Tibetan Medicine as a Western Narrative of Healing

1
Devin Gonier
Professor Ivette Vargas-O’Bryan
Department of Religious Studies
Final Report
Mellon Project 2008-09
Combining stories: Reading Tibetan Medicine as a Western

Narrative of Healing
This project was funded by the Carnegie Mellon Grant

from Austin College in 2008-09 under the supervision of
faculty-advisor Ivette Vargas-O’Bryan from the
Department of Religious Studies. My faculty advisor was
of critical help throughout the entire process, and took
great care in mentoring me in the project’s research and
writing. The research for this paper took place over the
course of a year in India (Dharmasala, Darjeeling,
Ladakh), Kathmandu, Nepal and Boulder, Colorado. It
involved interviewing ten Tibetan medicine doctors
throughout the regions and two religious experts, as well
as conducting library research in the U.S. The following
report will describe what I learned throughout the terms
of the grant about U.S. healthcare and Tibetan medicine.
The real narrative of dying now is that you die inside a machine1 –
Broyard
We are thus not at the end but at the beginning of the beginning, and
even with the best of tools, our task of negotiating the new healthcare
may be much more complex and multifaceted than initially realized. 2 –
Michael Cohen
It would be very useful for humanity if Tibetan and Western medicine

were practiced on a parallel basis. 3– The Dalai Lama
Introduction
Healing as we know and understand it today has both a historical
and cultural context. It has evolved and events will continue to change
it in the future. There will be technological advancements that improve
1 David B Morris, Illness and Culture in the Postmodern Age. California:

University of California Press, 1998. pg. 44
2 Michael Cohen, Healing at the Borderland Between Medicine and
Religion. North Carolina: UNC Press, 2006. pg. 161 (last sentence)
3 H.H. Dalai Lama. The Knowledge of Healing. Dir. Franz Reichle. Perf.
14th Dalai Lama, Dr. Tenzing Choedrak,. First Run Features, 2005.
Devin Gonier 2
our ability to treat future and current illnesses, but beyond this, the
discourse on health and the philosophical assumptions inherent within
the Western health model will adapt and evolve too. When many
Westerners think of the verb “heal” they carry with it the cultural
baggage that shape the way we understand healing, baggage like the
view that disease is something objective and that it can be cured
through objective processes. But, one must tread carefully in this
thinking, since different cultural and historical contexts change how a
person thinks of his or her body and what it means to heal. It is much
easier to see the effect cultural and social contexts have on medicine
by looking closely at the diversity of medicines throughout the world.
Different socio-cultural situations influenced or not by religion have
directed medicine and health in unique ways. Different types of
medicine have a long history of intersection and these intersections
continue to grow today. The focus of this paper will be specifically on
the intersection of biomedicine and Tibetan medicine, and it will argue
that current U.S. healthcare discourse creates barriers for religious
healing systems like Tibetan medicine. Unless cultural and institutional
changes are made, it will continue to be difficult for Tibetan medicine
and other healing systems similar to it to have a legally and culturally
accepted role in U.S. healing.
Thesis and Structure
This final report reflects upon findings that the U.S. healthcare
Devin Gonier 3
discourse and treatment process are predominately influenced by
scientific materialism and the hegemonic status of biomedicine in
healing. The U.S. healthcare discourse creates great difficulties for
alternative, complementary, and integrative models of healing, which
cannot be entirely reduced to a biomedical scientific model, to become
popular or legally acceptable in the U.S. This paper will draw heavily on
the views of postmodern medicine, because of its basic advocacy for
empowering marginalized voices in the pursuit of a more
heterogeneous healthcare system. The focus will be on the particular
relationship between Tibetan medicine and biomedicine in the U.S.,
and how this relationship can be improved based on the principles of
postmodern medicine. There are two supporting arguments. First,
postmodern medicine reconceptualizes the relationship between
religion and healing by disrupting the hegemonic biopolitical status of
secular healing in the U.S. In other words, postmodern medicine
creates space for religious healing in a system dominated by secular
healing. Second, the principles of postmodern medicine suggest a
heterogeneous globalization model, which resists what medical
anthropologist Vincanne Adams’4 calls erasure.
4 Vincanne Adams is a noted scholar of Tibetan medicine. She is a

medical anthropologist teaching at UCSF school of medicine. Her
notion of erasure comes from a work titled “Integration or Erasure:
Tibetan Medicine in the Contemporary World” that explores two
possible ways for different medical systems to integrate. She explains
the difference on page 110, “Integration in its best possible sense
results in the sharing and exchange of knowledge and practices, as
opposed to its opposite: the substitutions and erasure of one for the
Devin Gonier 4
The first section of this paper outlines some crucial concepts
about Tibetan medicine and also explains the status of complementary
and alternative medicine (CAM)5 in the U.S. The second section defines
the tenets of reconstructive postmodern medicine, and examines how
Tibetan medicine fits within the paradigm of postmodern medicine. The
third section outlines the deconstructive elements of postmodern
medicine, which critique biomedicine’s hegemonic status within the
U.S. After this description of postmodern medicine and its relationship
to biomedicine and Tibetan medicine, the paper will analyze how
religion and medicine intersect in the U.S. mainstream health care
system, and will suggest moving away from a system where secular
healing is hegemonic. Finally, it examines the concept of globalization,
and utilizing much of Vincanne Adams’ work, analyzes the biopolitical
role of the NCCAM6 and suggests a more heterogeneous model for
sake of incorporating the other.”

Vincanne Adams, and F. F. Li. "Integration or Erasure: Modernization at
the Mentsikhang." Tibetan Medicine in the Contemporary World Global
Politics of Medical Knowledge and Practice (Needham Research
Institute). New York: Routledge, 2008:110
5 Often times the terms alternative medicine, complementary
medicine, and integrative medicine get confused. Alternative Medicine
refers to treatments that are used instead of conventional medicine.
Complementary Medicine refers to treatments that are used in
conjunction with conventional medicine. Integrative medicine refers to
the process of taking two systems and attempting to bring their
philosophical and procedural qualities together in one combined form
of medicine. The section providing an overview of insurance
regulations and the National Center for Complementary and
Alternative Medicine (NCCAM) will refer to both Complementary and
Alternative Medicine, as understood by the NCCAM.
6 National Center for Complementary and Alternative Medicine
Devin Gonier 5
thinking about healing in the U.S. as a result of the application of
postmodernism. Based on some of the principles of postmodern
medicine, the paper concludes by suggesting that our healthcare
system should be more open to other forms of healing which cannot be
easily integrated into the biomedical secular model of thinking. Before
getting into background information about the U.S and alternative
medicine, Tibetan medicine will be summarized and its most basic
features explained in a way that makes its relevance clear.
Introducing Tibetan Medicine
The Basics
It is difficult to pinpoint the exact beginnings of Tibetan medicine
(called Gso ba Rig pa in Tibetan), especially since many believe it to
have a religious beginning originating from the Medicine Buddha
himself. The primary text of Tibetan medicine is the rbgyud-bzhi,
because it is the first text to outline all the essential features for
practicing Tibetan medicine. This text is still used today and it is
currently in the process of being translated to English at the Men Tsee
Khang in Dharamsala. One way of pinpointing a beginning for Tibetan
medicine would be to focus on the creation of this text, since it
represents the first synthesis of the main ideas and principles of
Tibetan medicine. Scholars who focus on the rbgyud-bzhi, like
Thakchoe Drugtso, put its beginning around 1126-1202 A.D. when

Devin Gonier 6
Youthog Yonten Gonpo and his son are thought to have authored or
consolidated the rbgyud-bzhi. 7
Structure of the Body:
Theoretically the body is viewed as a collection of three humors
(nyes-pa): Wind (rLung). Bile (Khris pa), and Phlegm (Bad-kan). When
these elements are in harmony, a person is considered to be healthy,
and when they are not in harmony a person has an illness of some
sort. These humors are further subdivided into 15 categories that are
much more specifically aimed at certain functions within the body.8
Thus, Tibetan medicine sees the body as a balanced system, where
different parts are interconnected and dependent upon the rest of the
whole in order to be functionally healthy.
Diagnostic technique
Typically a Tibetan medicine doctor or amchi uses three main
diagnostic techniques. Almost every visit will include an interview with
questions about diet, lifestyle, and symptoms, and a pulse reading. The
specific technique used for pulse reading is completely unique to
Tibetan medicine, although similar approaches are used in Chinese
medicine. Dr. Tenzin Choedrak, a senior personal physician for the
Dalai Lama notes that,
The movement of the wind is comparable to

what drives the waves of the ocean. Whenever
7 Thakchoe Drungtso, Tibetan Medicine: The Healing Science of Tibet.

Men Tsee Khang, Dharamsala: Drungtso, 2004: 23
8 Ibid. pg 108
Devin Gonier 7
a wave arrives, it makes a human being

advance. When it recedes it pushes him further
back. Once the wave is at its crest, it breaks. In
the human body this wave can be felt in the
pulse…Wind is responsible for all that moves in
the body.9
When pulse reading is explained in this way it often makes it easier for
western practitioners to bracket it off as religious practice. A person
could think of pulse reading as a religious or transcendental
investigation into the deeper energies of the body, but there is also a
scientific side to it that has strict guidelines and can take many years
to be fully grasped. The final diagnostic technique is urine analysis,
which is typically studied under very specific conditions (and is thus
less common with very minor illnesses) in order to better understand
the balance of humors within the body.
Treatment
Treatment usually consists of moxibustion (a type of treatment
using heated needles), cupping (a procedure where a vacuumed cup is
placed on the body to influence bodily channels), diet changes, Tibetan
herbal medication, or a change in lifestyle. Interviews are usually very
crucial in assigning the proper treatment. Tibetan medicine usually
involves non-synthesized combinations of herbs (sometimes up to
sixty) that are to be taken at low dosages frequently throughout a
period of time. Since the dosage is low and non-synthesized it can
9 Dr. Tenzing Choedrak. The Knowledge of Healing. Dir. Franz Reichle.

Perf. 14th Dalai Lama, Dr. Tenzing Choedrak. First Run Features, 2005.
Devin Gonier 8
typically be used with other Western drugs. Alfred Hassig, an M.D. in
Immunology, explains
Such a plant mixture can be extremely beneficial,

because the individual plants react reciprocally to
greater effect. Since the single components are only
present in small quantities any side effects they may
have are diminished in such a way that these plant
compounds are very effective and well tolerated.
That’s the problem with pharmaceutical substances:
being chemically determined uniform substances,
they exert a specific influence in the body and, in so
doing, often effects and side effects interfere.10
If properly diagnosed there is little to no risk involved in Tibetan
medicine. This is a huge reason why Tibetan medicine is popular. The
only disadvantage is that Tibetan medicine works slowly, whereas
biomedicine works quickly. Obviously, Tibetan medicine is not best for
every illness, but it can be an effective solution to many common
illnesses without being potentially harmful by having many unwanted
side effects.
Tibetan Medicine and its Effectiveness
When Tibetan medicine began to be introduced to Western
doctors (samples were given of its medicine for certain treatments)
there was a great deal of skepticism.11 One of Tibetan medicine’s
earliest introductions to the west came as a result of Karl Lutz’s
10 Alfred Hassig. The Knowledge of Healing. Dir. Franz Reichle. Perf.

14th Dalai Lama, Dr. Tenzing Choedrak. First Run Features, 2005.
11 Karl Lutz. The Knowledge of Healing. Dir. Franz Reichle. Perf. 14th
Dalai Lama, Dr. Tenzing Choedrak. First Run Features, 2005.
Devin Gonier 9
pharmaceutical company Padma AG in Europe in 1970, which began
manufacturing Padma 28 based on a recipe introduced by a
“Mongolian amchi-family Badmajew.”12 Eventually many of the doctors
that used the medicine were surprised by the effectiveness of the
treatment Padma 2813. In the documentary The Knowledge of Healing,
Dr. Isaac Ginsburg, a researcher in Microbiology and Bacteriology in
Jerusalem, outlines two major western illnesses that Tibetan medicine
has shown impressive success in treating.
Heart Attacks
First, as is widely known, “coronary heart disease is the single
leading cause of death in America” causing “heart attack and
angina.”14 Much of this can be linked to bad diet and poor exercise.
Cholesterol and many other substances create blockages within
important arteries that prevent blood flow.15 The Tibetan medicine
Padma 28 has shown great success in treating this problem. In the
documentary, The Knowledge of Healing, one patient is questioned
12 R. G. Landgraaf, "AMFI-TIBETAN MEDICINE RESOURCE GUIDE."

Alternative Medicine Foundation, Inc., Bethesda, MDˇ˝ - Welcome. 6
Apr . 2009. New Resource Guide. 03 May 2009
<http://www.amfoundation.org/tibetanmedicine.htm>.
13 Padma 28 is a medicine that can be taken once a month to improve
health in general. It is based on an ancient Tibetan formula called
Gabur. It is not available in the U.S., but can be found in Europe.
14 National Health and Nutrition Examination Survey (NHANES, 2005–
06). "Heart Attacks and Angina Statistics." American Heart Association.
2005-06. American Heart Association. 03 May 2009
<http://www.americanheart.org>.
15 Isaac Ginsburg, The Knowledge of Healing. Dir. Franz Reichle. Perf.
Devin Gonier 10
about his experience with Tibetan medicine. He explains that Tibetan
medicine saved his life. Severe blockage had been building up, and
surgery was unlikely to help solve the problem. Doctors had predicted
he would die within five months. But after taking Padma 28 and some
other herbal medications recommended, he was able to overcome his
problem. This patient argued that, “Sixty to eighty percent of all heart
operations wouldn’t need to be performed, if people used the same
treatment as I did! And although every professor and doctor had given
up on me, it’s been over ten years that I’ve managed to save
myself.”16
Cancer
Second, Isaac Ginsburg explains that when a person has cancer a
tumor caused by malignant cells develop. If the tumor does not spread
the cancer can be cured by removing it through surgery. But, if the
tumor is broken into smaller pieces it can travel and spread throughout
the body. Blood cells are capable of destroying 99.9% of small bits of
tumor that travel through the blood, but if the remaining .1% manage
to create another tumor in a vital area a person is likely to die.17
Ginsburg explains that cancer patients “are dying because of the
spread of cells,” and that
we can already prove that in the presence of the
16 The Knowledge of Healing. Dir. Franz Reichle. Perf. 14th Dalai Lama,
Dr. Tenzing Choedrak,. First Run Features, 2005.
17 Isaac Ginsburg, The Knowledge of Healing. Dir. Franz Reichle. Perf.
Devin Gonier 11
Tibetan drug, that the tumor cells are not able to

take a large molecule from the vessel wall and break
them into small pieces. So we hope that in this
collection of materials in the Tibetan drug we can
find the component which is good for inhibiting
tumor cells growth and invasion.18
Research being done right now with Tibetan medicine could
prove crucial in discovering the cure for cancer.
There are many other areas that credit Tibetan medicine
as being successful, such as treatment of chronic kidney
problems. Currently the Men Tsee Khang in Dharmsala is working
with Western doctors on a number of illnesses in order to try and
create better cures to diseases that have been extremely
problematic for biomedicine. Tibetan medicine’s potential is only
barely being realized, and if it receives the recognition it
deserves (a commonly cited problem by many of the doctors I
interviewed at the Men Tsee Khang) the potential for its benefit
could be very great indeed. Furthermore, in comparison to other
pharmaceutical drugs, and the diagnostic procedures of western
medicine, Tibetan medicine is significantly cheaper and has little
to no side effects. Thus, when one takes cost into account (which
is a very significant factor for many people), and when one
considers the great deal of suffering that occurs from painful and
often dangerous treatments performed by western doctors, the
benefit and effectiveness of Tibetan medicine could prove
18 Ibid.
Devin Gonier 12
extremely great.
Tibetan Medicine and its Religious Influences
There are a few important features of Tibetan medicine that are
religious and that need to be explained in order to make sense of
many of the difficulties Tibetan medicine experiences when it is
introduced to the West. It is quite common for patients to first
encounter the religious elements in Tibetan medicine when receiving
treatment from amchis, because when they are “giving the
medication” sometimes the amchi “either prays or recites mantras.”19
One of the most crucial religious aspects of Tibetan medicine is that
the rbgyud-bzhi, a foundational medical text for Tibetan medicine,
contains elements influenced by religion. This text serves as the
synthesis and foundation for Tibetan medical knowledge. Doctors
trained at the Men Tsee Khang College in Dharmsala must fully
understand the rbgyud-bzhi. Usually large portions of the rbgyud-bzhi
must be memorized in order for a student to officially become an
amchi.
rbgyud-bzhi is traditionally translated as ‘the four tantras’, and is
shortened from its full title, “bDud- rsis sNying-po Yan-lags brGyad-pa
gSang-ba Man-ngag gi rGyu,” which means ‘The Essence of the Secret
19 H.H. Dalai Lama. The Knowledge of Healing. Dir. Franz Reichle. Perf.
Devin Gonier 13
Instruction on Eight Branches.’ 20

The four tantras of the rbgyud-bzhi
are the Root Tantra (rTsa-rGyud), the Explanatory Tantra (bShad-
rGyud), the Quintessence Oral Instruction Tantra (Man ngag-rGyud),
and the Subsequent Tantra (Phyima-rGyud). 21
rbgyud-bzhi and its Origin
The origin of the rbgyud-bzhi is somewhat controversial. According
to Dr. Tsering Thakchoe Drungtso22 there are four competing
hypothesis about the text’s beginning. The first is that it is the exact
words of Sangye Menla (the Medicine Buddha). The second is that
Vairochana and Kashimiri Pandi Chandrananda translated it from the
Sanskrit text Legs-sByar nas bsGyur-ba. This is probably the least
tenable hypothesis due to a number of inconsistencies; one is that it
would imply that Tibetan medicine originated from Indian culture
(when there are many references of ancient Tibetan cultural icons and
medicinal procedures like pulse diagnosis, which did not appear in
Ayurvedic medicine until 200 years after the rbgyud-bzhi was written).
The third interpretation is that it is a “rediscovered treasure” (gter ma)
after being hidden by Guru Padmasambhava in the “central pillar of
Samye monastery and later discovered by gTer-sTon Grawa
mNgonshes” around 1012-1091 A.D.23 Finally, many believe that

21 Ibid.
22 Ibid. pg. 23
23 Ibid. pg. 23
Devin Gonier 14
Youthog Yonten Gonpo and his son were the authors of the rbgyud-
bzhi, and it is largely based on an early medical text called Zhang
Zhung around 1126-1202 A.D. Dr. Drungtso suggests that it is not the
direct word of the Medicine Buddha based on a few inconsistencies
within the text itself and the history of some of its principles in Tibetan
culture. Thus, while it might not be a popularly held belief that the text
originated from the Medicine Buddha directly, its references to the
Medicine Buddha and some of its other structural components cause it
to be considered a “divine work,” and “traditional accounts of text or
the history of Tibetan medicine…place the work in a category with the
other sutras and tantras.”24
Rbgyud-bzhi and its Content
The second important feature of the rbgyud-bzhi to look at is its
content. There are 5,900 verses spanning over 156 chapters in the
rbgyud-bzhi25. There is a diversity of topics explored throughout each
tantra, and each tantra has a specific purpose. The rbgyud-bzhi begins
with the prayer to the Medicine Buddha, “Homage to the King of
Aquamarine Light and Supreme Benefactor, who has attained perfect
fulfillment and overcome all obstructions, he who has reached the
ultimate reality and become the fully-endowed conqueror who
24 Todd Fenner, The Origin of the rbgyud-bzhi: A Tibetan Medical

Tantra. Snow Lion Publications. Pg. 461
25 Thakchoe Drungtso, Tibetan Medicine: The Healing Science of
Tibet. Men Tsee Khang, Dharamsala: Drungtso, 2004: 36
Devin Gonier 15
surpasses all bounds.”26 This prayer immediately sets the structure and
tone of the rest of the text as being inspired by Buddhist principles.
The entire text explores eight branches of medicine: The body,
pediatrics, gynecology, harmful evil spirits, wounds inflicted by
weapons, toxicology, rejuvenation, and aphrodisiacs.27 The fourth
branch immediately implies certain religious beliefs – i.e. the belief in
evil spirits. Chapter 73 and Chapters 77-81of the Quintessence Oral
Tantra, and Chapter 9 of the Explanatory Tantra deal directly with
spirits that have a direct effect on human health. Chapter 13 (called
rGyun-Spyod) of the Explanatory Tantra deals with behavior (a
potentially major cause for illness) and the ways in which certain
religious practices and moral acts can have a strong effect on illness.
Finally, discussions about the amchi’s role and treatment of the patient
in chapters 25 (Ngan-gYo-sKyon-brtag) and chapter31 (sMan-pa’I le’u)
are very invocative of the Buddhist concept of Bodhicitta.
The rbgyud-bzhi, both in its origin and content, largely incorporates
Buddhist and Bon imagery. Because of the tendency of biomedicine to
value only what can be scientifically proven, there is often great
controversy when western doctors try to understand Tibetan medicine
through the rbgyud-bzhi. As Craig Janes notes, “It is the overarching
26 Yeshi Dhonden, and Jhampa Kelsang. The Ambrosia Heart Tantra.

New Delhi: Educa Books /Paljor pg.1 This text contains the translation
of the Root Tantra, and the second half of the Explanatory Tantra from
the rbgyud-bzhi.
Men Tsee Khang, Dharamsala: Drungtso, 2004. pg. 36
Devin Gonier 16
theoretical logic found in the core texts, a logic which references
principles that might be glossed as ‘spiritual’ or ‘religious,’ that has
become entangled in the debate over the distinction between the
sacred and the scientific.”28 The rbgyud-bzhi is a foundational text for
Tibetan medicine, and Buddhism and Bon heavily influences it.
Karma
Furthermore, karma plays an important role in Tibetan medicine. In
the thirteenth chapter of the Explanatory Tantra, it specifies two types
of actions that can affect illness and more broadly about happiness:
sacred and worldly activities. The rbgyud-bzhi recommends doing
worldly activities in a safe and healthy way; for example, avoid
dangerous places, and get enough sleep. Sacred activities are
activities that can also have a great impact on a person’s health
because they promote good karma. The rbgyud-bzhi states,
Living in accordance with the religions of the world is the

foundation of all virtues…without a religious approach to
life happiness itself is a cause of discontent...Subdue the
actions of your body, speech and mind and have a
generous attitude free of attachment.29
The religious foundation reflects of Buddhist principles on how one
should live their life in order to be happy and healthy.
In Tibetan medicine, there are traditionally four classifications of
illness. There are “101 superficial or ostensible diseases (ltar snang
28 Craig R. Janes, "Buddhism, Science, and Market: the globalization of

Tibetan medicine." Anthropology and Medicine 9 (2002): 275
29 Yeshi Dhonden, and Jhampa Kelsang. The Ambrosia Heart Tantra.
New Delhi: Educa Books /Paljor: 106-107
Devin Gonier 17
‘phral-nad), 101 diseases of this life time (yong grub tshe-nad), 101
diseases of harmful evil spirits (kun brtags gdon-nad), and 101
untreatable karmic diseases (gZhan dbang sNgon las).”30 Karmic
diseases are diseases that simply don’t respond to treatment, and no
possible explanation other than karma can be attributed to them. The
diagnosis usually consists of treatment using whatever medicine that
may be helpful (but will not result in a cure) and typically consultation
with a lama alongside pujas31.
Many have heard stories of people with conditions that would
normally seem curable either through biomedicine or Tibetan
medicine, but for some reason the treatment seems to consistently
fail. For example, while in Kathmandu, I interviewed a Geshe32 at the
White Temple named Karma Gyurme who claimed to have a karmic
disease. He had consulted biomedical and Tibetan medicine doctors
about the problem (stomach pains) and none could explain or cure his
illness. However, he was not bitter about having a karmic illness. In
fact, when I asked him how having a karmic illness effected him, he
quoted Santideva saying, “If anything happens that can be changed,
why worry, it can be changed; and if anything happens that cannot be
changed what is the point in worrying?” In Geshe Gyurme’s mind, a
30 Thakchoe Drungtso, Tibetan Medicine: The Healing Science of

Tibet. Men Tsee Khang, Dharamsala: Drungtso, 2004: 371
31 religious offering ceremonies
32 A Geshe is an academic degree within the Monastic tradition that
requires a person to be a monk and to have studied for the degree
from a time span of 12-20 years.
Devin Gonier 18
karmic illness was an opportunity to work off negative actions from the
past. Suffering from illness now, meant that he would not have to
suffer some terrible tragedy in the future to make up for his evil deeds
of the past. Thus, built into the very structure of Tibetan medicine is
the Buddhist principle of karma. Our bodies are constantly changing,
and this change is a result of our actions. Part of the justification for
this is that the humors themselves are manifestations of the three
poisons; “rLung (wind) is connected with desire and attachment,
mKhris pa (bile) with hatred, and Bad-kan (phlegm) with ignorance.”33
These actions directly affect the physical humors. Thus, karmic
illnesses are incurable, because the body has changed as a result of
behavior, not behavior like smoking or eating too much, but moral
behavior.
The Spirit World and Demons
There are also spirits and demons that have an effect on illness.
As was briefly mentioned earlier, Tibetan medicine states that there
are 101 diseases caused by harmful spirits. The idea that spirits are a
causal agent in disease immediately presents problems for most
Western doctors. Most cases of possession or spiritual influence deal
with the humor rLung (wind), which typically is most associated with
the mind, and is the pervasive life force of the body. Dr. Terry Clifford,
33 Jampa G. Dagthon, "The Importance of Astro. Science in Medicine."

Tibetan Astronomy and Astrology: A Brief Introduction. Dharamsala,
India: Tibetan Medical and Astro. Institute, 1995:34
Devin Gonier 19
a psychiatrist who took great interest in Tibetan medicine and
psychiatry, presents the variety of interpretations regarding demons
when he writes,
“An uneducated Tibetan might actually believe in them

<demons> as malevolent embodied hobgoblins; a yogi
might think of them as negative energies or fields of force
that exist in the universe; and yet more sophisticated
lamas and doctors and laymen might perceive them as
unconscious tendencies deep within the psyche that have
the power to overwhelm normal consciousness.”
He defines demon very broadly as, “any unseen force that obstructs a
psychological or spiritual development.”34 There are eighteen different
types of spirits that can affect the body. For example, there is a spirit
called a Klu or Naga, which is a “serpent spirit or spirit, which reside on
land and in water.” When possessing a person these spirits cause
sickness and symptoms like, “fondness for meat, milk and other dairy
products,” constant licking of lips, and the desire to lay on ones belly
rather than back.35 Sometimes these spirits can be upset by pollution
or mistreatment of the land, and sometimes they may even cause
epidemics within a small community. However one chooses to consider
the ontology of such spirits, it is clear that they play a part in the
treatment and understanding of the body for Tibetan medicine.
34 Dr. Terry Clifford, "Tibetan Psychiatry and Mental Health." Bulletin

of Tibetology 1993 (Aspects of classical Tibetan Medicine). Gangtok:
Namgyal Institute of Tibetology, 1993:10
Devin Gonier 20
Astrology
Tibetan medical hospitals are called “Men Tsee Khang,” which
literally breaks down to Men (medicine) Tsee (Astrology) khang (house)
meaning Tibetan medicine and Astrology House. Astrology is typically
also required material for most students studying at the Men Tsee
Khang institute in Dharmsala. In fact, “the truly effective healer within
the Tibetan tradition will have studied both medicine and Astro.
Science, since the influences on the body comes from both within and
without.”36 In order to understand the role of spirits, you need to
understand astrology and the role of the elements. Tibetan medicine
describes five elements that make up the existence of the entire
universe; “medicine observes Fire, Earth, Water, Air and Space,
astrologers observe instead Fire, Earth, Water, Wood, and Metal.
[Elements that are adapted from Chinese medicine]”37 These elements
also make up the various aspects of the body and play an important
part in the formation of the humors. Whereas, Tibetan medicine
focuses on the internal relation of the elements as they manifest in the
harmony of the humors, astrology focuses on the outside of the body
by looking to places like the stars, the seasons, and the temporal
location of the individual in relation to the time of the universe. By
doing this, astrologers are able to diagnose present problems or future
36 Jampa G. Dagthon, "The Importance of Astro. Science in Medicine."

Tibetan Astronomy and Astrology: A Brief Introduction. Dharamsala,
India: Tibetan Medical and Astro. Institute, 1995:29
37 Ibid. Pg. 36
Devin Gonier 21
problems that might develop as a result of changes in the universe.
Thus, effective amchis are able to understand the balance of the
elements both inside and outside the body through a holistic
understanding that transcends even the body.
Some religious features of Tibetan medicine might eventually be
explained through scientific study, and other features of Tibetan
medicine might be transformed to more modern scientific practices.
This is something that the XIVth Dalai Lama has emphasized should be
the case, and he recommends in certain situations amending old
religious beliefs on the basis of modern development in a cautious
manner. Based on some traditional views, replacing these religious
aspects with science alone would be a violation of the very integrity
and coherence that makes Tibetan medicine function. Tibetan
medicine as an effective religious healing system has great potential
for success in the U.S., but in order to understand how Tibetan
medicine can fill an important demand in the U.S., it is important to
explain how demand for healing has changed in contemporary
healthcare for the U.S.
Background: The Status of Complementary, Alternative, and
Integrative Medicine in the U.S.
In the United States our healthcare system has become more
diverse, but the supply of diversity in healing is mitigated by a few

Devin Gonier 22
policy factors that will be discussed in this section. The Enlightenment
Period witnessed the rise of scientific thinking. Science became a
coherent framework that began to have great sway over the common
person’s understanding of the world and their body. With the
introduction of new technologies and techniques, modern medicine
throughout the 20th century developed at an astounding rate, and was
able to radically change the way we understand the human being and
treat suffering.
Demand for CAM and the NCCAM
In the U.S.A. demand for CAM has grown a great deal over the
past few decades. According to the National Center for Complementary
and Alternative Medicine (NCCAM), “36% of adults are using some
form of CAM. When megavitamin therapy and prayer specifically for
health reasons are included in the definition of CAM, that number rises
to 62%.”38 According to a different study done by “David Eisenberg39
and colleagues (1998) that appeared in the Journal of the American
Medical Association it estimated that in 1997, 42.1 percent of all adult
Americans had used some form of alternative therapies (including
chiropractic, relaxation techniques, biofeedback, and acupuncture) in
the past twelve months, a significant increase from the 33.8 percent
38 PM Barnes, B. Bloom, R. Nahin “Complementary and Alternative

Medicine Use Among Adults and Children: United States, 2007.” CDC
National Health Statistics Report #12. December 2008
39 David Eisenberg is a Director of the Osher Institute at Harvard
Medical School and the Division for Research and Education in
Complementary and Integrative Medicine.
Devin Gonier 23
estimated to have done so in 1990.” 40 This indicates that there is a growing demand for
CAM in the U.S. People are beginning to become more interested in treatments other than the exclusive
41
use of conventional allopathic biomedicine.
As will be developed more in the following sections the NCCAM
uses the principles of biomedicine as templates for legitimizing
alternative medicinal treatments in the U.S. The consequences of the
way in which the common American not only treats their illnesses, but
also on how they understand their body have been profound. U.S
society is changing, but policy is struggling if not completely failing to
keep up. Patients seeking medical treatment outside of traditional
allopathic medicine encounter problems with insurance company’s lack
of coverage, and physicians from other medical philosophies encounter
problems with legally being allowed to practice medicine. Much of this
change in demand makes sense when one considers the ideological
change that has been occurring in U.S. society and throughout the
world from the modern to the postmodern. In order to understand the
cultural and philosophical reasons for this struggle to achieve a
heterogeneous healthcare system this paper will draw heavily upon the
40 Robert Tillman, "Paying for Alternative Medicine: the Role of Health

Insurers." Annals of the American Academy of Political and Social
Science 583 (2002): 64-75.1
41 Many doctors view the word allopathic to be pejorative, and do not
accept its use. For the sake of this paper it will refer to western
medicines that use biomedical epistemologies and are the result of
Descartes analytic principles that founded reductionism. The term is
most commonly used to juxtapose medicines like Osteopathy, which
would be considered holistic, from other western medicines that are
not holistic.
Devin Gonier 24
principles of postmodern medicine.
Postmodern Medicine
What is Postmodernism?
Lyotard defines Postmodernism in broad terms as,
“an incredulity towards metanarratives. A

metanarrative is a theory or story that passes itself
off as a truth without exception, generalized truths
that pretend to be true for all objects in a category,
such as all Priests are pure, all people in a certain
country think a certain way, or science is the best
approach to solving all human problems.
Metanarratives, it seems to the postmodern, are
myths belonging to modernity, myths that simplify
and blind us to subtleties and exceptions around us,
myths that are often more false than true, but
seldom completely true.”42
Michel Foucault, one of the premier thinkers of postmodernism,
argues that within every society there is a complex system that he
calls the microphysics of power. These systems of power discipline our
bodies and produce certain actions that are complicit with a set of
assumptions within a discourse. Various systems of power
conceptualize truths in terms of the processes involved in the
application of power. As Vincent B. Leitch notes of Foucault,
Nothing-whether selves, desires, or truth-is external

to the productive power/knowledge that creates the
categories by which it is known. Thus, the truth to
which dissidents appeal is no less a product of
interested strategies- in this case, their own – than
the truth spoken by the officials whom they oppose.
Truths are not all born equal, because some
discourses are more powerful than others. But
42 L. Shawver, “Notes on reading the Birth of the Clinic.” 16 May

1998.
http://www.california.com/~rathbone/foucbc.htm
Devin Gonier 25
Foucault does not recognize any component of truth

separate from power.43
Thus, truth is a function of power, it is something which power
produces and is a product of discourses that are shaped by power
structures. For example, in our justice system a person is considered
truly guilty after he has gone through a procedural process in which
people evaluate him and his actions in relation to a system of laws.
This truth of guilt is a product of the power people place in the judicial
system and its processes. In this way, a modernist metanarrative
might say that the justice system upholds truth by determining what is
true or false regarding a particular persons actions based on a
particular process (i.e. two sides compete in order to convince a jury of
peers that their position is the true position). Another metanarrative
that postmodern medicine will be examining closely are those
involving healing and healthcare in the U.S. The dominant framework
for understanding the body and identifying the correct procedures for
healing would be the biomedical narrative. If the metanarrative that
‘biomedicine is the only way to conceptualize and cure the body’ is
accepted in our society, then biomedicine is hegemonic at the expense
of other narratives of healing. In other words, the truths and
knowledge people have about their bodies is the product of discourses
on the body that exist within a system of power. At the moment, this
43 "Michel Foucault." The Norton Anthology of Theory and Criticism.

Ed. Vincent B. Leitch. New York, NY: Norton & Company, Inc., 2001.
1620.
Devin Gonier 26
system of power is dominated by the discourse of biomedicine, so what
biomedicine asserts becomes the dominant truth of the body, because
it holds more power than other healing systems in our healthcare
discourse.
Postmodernism and Heterogeneity
One aspect of postmodernism, and postmodern medicine
especially, is the emphasis on achieving a heterogeneous discourse.
Rather than one narrative of healing (biomedicine) having biopolitical
hegemony over the rest of society, postmodernists believe that
multiple narratives of healing can coexist. As David Morris44, a premier
postmodern medicine thinker notes, “Postmodernism is normally
described as inherently heterogeneous marked by the absence of a
single dominant style or mode of thought. It splinters unified
discourses, decenters orthodox beliefs, validates marginal positions
endlessly deferring full knowledge, adding supplement on
supplement.”45
Medicine is not just a system of healing, but also a power
structure. Medicine is a power structure in so far as it represents our
understanding of our bodies and how we care for our bodies. It is a
cultural force of discipline by virtue of what Foucault has
44 David B. Morris, winner of a 1992 PEN award for The Culture of Pain
(California, 1991) and author of the award-winning Alexander Pope:
The Genius of Sense (1984), lives and writes in Albuquerque, New
Mexico.
45 David B. Morris, Illness and Culture in the Postmodern Age.
University of California P, 2000: 136
Devin Gonier 27
called a clinical “gaze” that transforms the body into an

object of scientific scrutiny. Patients often note how the
power implicit in the physician and in the medical setting
can reduce us to a state of passive and dependent
helplessness, in which we sit for hours in a crowded waiting
room until the busy doctor at last finds time to see us.46
The medical discourse and the power relationships within it have a
large impact on our identity and the way we conceptualize our
relationship with our body and the rest of society.
The state regulates narratives of healing because a paternalistic
state always sees it as advantageous to have some sort of systematic
bureaucratic control over the body (what Foucault calls biopower).
Thus, many governments including the U.S. federal government have
in place certain federal organizations in charge of regulating what
qualifies as legitimate medicine. Arthur Kleinman47 writes of
biomedicine that,
in the postmodern state, biomedicine has come to

serve a major political mission… it has outstripped its
own professional autonomy and become inseparable
from the state. In Western countries, biomedicine
occupies the chief legitimized role for supplying health
service to the populace, a role48, as Waldrum points
out, that it ‘protects with diligence.’ Chief among its
repertoire of responses to heterodox challenges is its
use of state power to both generate and enforce the
ground rules and criteria for establishing efficacy.
Alternatives to biomedicine, when they cannot be set
aside as inefficacious or simply labeled as quackery,
are often co-opted or ‘tamed’ by state-supported
46 Ibid. pg. 146

47 Arthur Kleinman is a professor of medical anthropology and cross
cultural psychiatry at Harvard University.
48 Craig R. Janes, "Buddhism, science, and market: the globalization
of Tibetan medicine." Anthropology and Medicine 9 (2002): pg. 35
Devin Gonier 28
biomedicine.49
In the U.S. one of the primary organizations for regulating what
qualifies as legitimate medicine is the NCCAM. The movement called
postmodern medicine is a movement which focuses on healthcare
through a postmodern lens, and which typically advocates diverse
ways of thinking and conceptualizing the body and healing.
Constructive Postmodern Medicine
Multidimensional Realism
Elliott S. Dacher50 helps to identify some of the central
components and advocacies of postmodern medicine. The first
component he discusses is called Multidimensional Realism. It is
neither radical subjectivism nor scientific materialism, but is a
“multidimensional amalgam of sensory and non-sensory knowledge.”51
Neither radical subjectivity, nor radical objectivity is as fruitful as they
can be when both are given value. It is important to recognize that this
is something that develops historically. Healing was once very religious
and subjectively understood, then after the scientific revolution of the
enlightenment, medicine tended towards objective science as a
metaphysical foundation. Postmodernism however acknowledges that
both the subjective and the objective are critical parts of the healing
49 Ibid. pg. 36
50 Elliott S. Dacher is an M.D. that has written a number of books on
healthcare including Integral Health: The Path to Human Flourishing.
51 Elliot Dacher, M.D. "Towards a Postmodern medicine." The Journal
of Alternative and Complementary Medicine 2 (1996): 532.
Devin Gonier 29
process, and the exclusion of one for the other inevitably reduces the
effectiveness of healing. Healing should include both subjective
understandings of health that account for perceptions of pain and the
power of the mind in healing the body, and objective standards for
evaluating the disease as a physical entity to be treated through
physical processes like medicine. This aspect is critical in the
understanding of religion and healing (as will be discussed later on).
What should be taken away from this is that, science and religious
modes of healing do not have to be exclusive of one another, and
when techniques from both are used in a complementary way, a more
successful style of healing will result. For Tibetan medicine, subjectivity
and objectivity come together in the sense that the subjective
condition of the mind, religious experiences, and karmic consequences
are just as valuable as the objective circumstances and physiological
circumstances in treating illness.
Intentionality
The second quality that Dacher emphasizes is Intentionality,
which validates the “causal nature of consciousness which is
individually willed.”52 Both Intentionality and Mutlidimensional realism
acknowledge the value of consciousness and the mind in the healing
process. Intentionality, postmodern medicine advocates, is the
importance of understanding sickness as an illness rather than a
52 Ibid.
Devin Gonier 30
disease, giving place to subjectivity as an agent in healing rather than
a passive recipient of the objective disease. Once again, this aspect
opens up new possibilities for understanding the techniques of
religiously inspired healing. Religious techniques tap into the deeper
more subjective aspects of consciousness, and by doing so those
techniques can cure the illness, but sometimes not necessarily the
disease. Expanding our conception of being unhealthy to include the
subjective term illness and the objective term disease creates space
for the more ritualistic modes of healing inspired by religion. Dacher’s
principle of intentionality is also relevant to Tibetan medicines account
of karmic or demonic illnesses, which do not have scientific
explanations based upon universal laws. Tibetan medicine teaches that
certain states of mind produce imbalances in the body and qualities
that might be dismissed as subjective are causally linked to the more
objective physiological elements of the body.
Holism
The third quality that Dacher focuses on is Holism, which rejects
the duality of mind and body, the subjective and objective, and other
such dualities in exchange for the belief that they remain
interconnected. In other words, part of the problem with scientific
materialism and radical subjectivity comes about as a result of thinking
of objectivity and subjectivity in a completely binary manner. A deeper
understanding and application of both as one interconnected whole is

Devin Gonier 31
essential for effective healing. One of the bigger criticisms of
biomedicine (as will be noted later on) is that it views the mind as a
biological entity and the body as a machine, which prevents the
possibility of healing via the mind. However, Tibetan medicine believes
the mind is crucial in the healing process, and it emphasizes practices
that are aimed at lifestyle choices and religious practices that utilize
the mind in the process of healing.
Clearly, the previous three elements of postmodern medicine are
related to each other. The first understands that subjective and
objective approaches can work together. This idea is related to the fact
that consciousness and the subjective elements of consciousness can
have an effect on the objective physiological body. And, finally Holism
breaks down the separation between the mind and the body, which is
consistent with the belief, that consciousness and more subjectively
understood approaches to healing could be effective.
Personal Authenticity
The final characteristic is Personal Authenticity, which empowers
the individual beyond the “authority from belief systems, institutions,
and professionals” by “recognizing that authentic individualism comes
into being in the context of relationship.”53 The dynamic of healthcare
is evolving away from power structures where the patient has no real
53 Elliot Dacher, M.D. "Towards a Postmodern medicine." The Journal

of Alternative and Complementary Medicine 2 (1996): 533
Devin Gonier 32
influence in their own healing process. For example, the movement
away from reductive medicine, where healing is understood as a
treatment of symptoms, to the view that healing should be about
locating the causes of illness, results in active dietary and lifestyle
changes on the part of the patient. In other words, postmodern
medicine advocates a system where people can take an active role in
their own health, and can develop their own specific view about how to
treat it. This is made more possible in a heterogeneous healthcare
system, because a person can make the choice about what type of
healthcare is the best fit for them.
Comparing Gray and Dacher
J.A. Muir-Gray,54 writer of “Postmodern medicine,” also makes a
few important observations about postmodern medicine. His
observations are much less theoretical and are aimed at practical and
concrete applications. Rather than articulating all of his observations,
this paper will focus on the few that are most relevant to the argument
presented, and will explore the ways in which a healthcare system with
both Tibetan medicine and biomedicine reflects the advocacy of
postmodern medicine. Many of Gray’s ideas are similar to Dacher’s.
Gray’s principle of a Value Based Healthcare and his emphasis on
Experience over Satisfaction of Care really address some of the ways in
which the entire process of allopathic biomedicine can be overly
54 J.A. Gray has been involved with Public healthcare for over 25 years.
Devin Gonier 33
reductive and mechanistic. Gray’s point is that the doctor’s visit should
involve “better verbal and non verbal communication, and a style of
consultation and decision making that involves and empowers the
patient.”55 Thus, the patient and the doctor’s relationship should be
one that is less mechanistic and open to the views and opinions of the
patient, since it is their body that is in danger.
Tibetan medicine accounts for this problem of disempowerment
and over-mechanization on a number of levels. Most of the diagnostic
procedures in Tibetan medicine come from detailed questioning that is
meant to find the root cause of imbalances within the body.
Treatments are always specific to the patient. In other words, a
biomedical doctor treats the patient by attacking the disease, but the
Tibetan medicine amchi treats it by understanding the body of the
patient and the ways in which imbalances have developed. Thus, a
biomedical doctor would most likely treat a group of people exhibiting
one type of disease in roughly the same way, but a Tibetan Medical
doctor might treat the same biomedical illness in different ways based
on the specific body type of the patient.
Furthermore, Grays’ points about Treating Disease vs Healing
dis-ease and his account of multiple realities address the need for
viewing the illness as something that has both subjective and objective
components. Both of these ideas have already been addressed through
55 J.A. Gray, "Postmodern medicine." Lancet Oct 30 (1999): 1552

Devin Gonier 34
the Dacher’s account of utilizing both subjective and objective
elements in healing by placing emphasis on consciousness as an agent
in the healing process.
The various elements of postmodern medicine that have been
articulated here can be mostly summed up by a general suspicion of
the purely objective and scientific approach to medicine. Gray notes
that, “ Postmodernism also challenges the objectivity that science has
claimed is its defining characteristic as spurious and unsupportable,
and although many different theories are encompassed by the term
“postmodernism,” a suspicion of science lies at the core of such
theories.”56 Postmodern medicine is not trying to suggest that science
ought to be eliminated from medicine and healing. Rather, it is
suggesting that objective approaches to healing have become for
various social reasons the exclusive mode of thinking about and
treating the body. The effects have been that the patient becomes
disconnected from the healing of their own body, and the process of
healing has become less about meaningful human interaction, and
more about a market driven exchange of goods and services meant to
stream line the elimination of symptoms. If the healthcare system
opens itself up to different epistemologies (epistemologies that
incorporate subjective approaches to healthcare as well as objective
approaches) of healing, then there can be more of a balance between
56 J.A. Gray, "Postmodern medicine." Lancet Oct 30 (1999): 1550

Devin Gonier 35
the purely subjective and purely objective modes of healing.
Criticisms of Postmodernism
One of the most relevant and effective criticisms of viewing
postmodernism as a tool for expanding the interaction of medical
epistemologies comes from Allen Wallace’s Buddhism and Science.
Wallace argues that there is great potential for Buddhism and Science
to collaborate on trying to further our understanding of this world. For
example, Wallace’s book includes discussion about the potential for a
productive discussion between Quantum scientists and the Buddhist
philosophers in understanding complex problems of existence. In a
section called, “The Dogma of Postmodernism” Wallace argues that
postmodernism undermines the potential for Buddhism and science to
cooperate in the advancement of knowledge. If Wallace were correct
then this would do great damage to the position that postmodern
medicine could facilitate a more balanced healthcare system in which
Tibetan medicine (largely built around Buddhist principles) can grow
along side the scientifically based biomedicine.
Wallace chooses to focus on “Jackson’s postmodernism,”57 which
he considers dogmatic. Wallace might be correct about Jackson’s
specific rendition of postmodernism and perhaps his dogmatic
application of postmodernism, but this paper will argue a more
57Alan Wallace, Buddhism and Science. Columbia University Press,

2003pg. 23
Devin Gonier 36
moderate form of postmodernism that is centered around thinkers like
Morris, Dacher, and Gray who argue for postmodern medicine
specifically.
Wallace’s first criticism is that Jacksons’s postmodernism
emphasizes cultural particularism, “which asserts that different
societies are culturally unique, incommensurable and hence
fundamentally unknowable by outsiders. This would imply that various
schools of Buddhism are culturally unique to the Asian societies in
which they developed, therefore their theories and methods of inquiry
cannot be compared to those of science.”58 This is a good point, but
does not represent the way many postmodernists choose to interpret
the role of culture. For instance, Bell Hooks argues that postmodernism
can be a huge step in the advancement of civil rights in the U.S.
Postmodernism allows the recognition that we are all socially and
culturally constructed creatures, and that we should each respect each
other for our uniqueness. Wallace does not consider those
postmodernists that want to protect the autonomy of the unique
culturally produced individual by preventing hegemonic narratives
from silencing marginal voices. This could be misinterpreted as the
position that says all narratives are mutually exclusive so that
everyone is speaking a different language and there is no room for
collaboration. But in reality postmodern medicine (and more
58 Ibid. pg. 20-21

Devin Gonier 37
specifically the way in which I choose to interpret postmodern
medicine, especially within the context of Tibetan medicine and
biomedicine in the U.S. heath care system) creates a framework of
mutual respect in which dialogue is generated with the premise that
differences ought to be celebrated and appreciated by acknowledging
the cultural uniqueness of each individual.
Wallace then criticizes Foucault in particular. He suggests that
Foucault reduces religion to nothing more than a power mechanism. In
Foucault’s defense, what he is doing is choosing to focus on power
mechanisms. This criticism represents a fundamental
misunderstanding of Foucault’s methodology. Foucault’s methodology
is meant to explain how contemporary discourse has developed as a
result of social circumstances in the past and that the contemporary
discourse is shaped by various power structures that have developed
and become more or less powerful because of historical events.
Foucault is not asserting that all religions are wrong, and serve a
purely social disciplinary function. Rather he is demonstrating how
certain historical developments have arranged discourse in a way that
is shaped by the power of certain ideologies. This criticism would be
akin to suggesting that an anthropologist reduces religion to
something that is only a cultural product. Just because the
anthropologist evaluates religion through a cultural lens does not imply
that the anthropologist views religion as something that is only

Devin Gonier 38
culturally produced and has no right to transcendental claims.
Along these lines, Wallace also criticizes Foucault, because
Foucault argues that there is no absolute truth, and “the insistence on
the lack of absolute truth in any worldview other than postmodernism
appears to be one of the fundamental articles of faith of this dogma,
which indicates its close similarities with scientism and other forms of
fundamentalism.”59 Wallace argues that postmodernism’s claim that
there is no absolute truth is itself a truth claim, which makes
postmodernism dogmatic in so far as it grants itself a truth claim, but
denies all other ideologies such a privilege.
However, Foucault’s position is more complex than simply the
rejection of absolute truth. In order to respond to this criticism a brief
return to Foucault’s explanation of truth will be helpful. Foucault
believes that truth and power are related. He argues that discourse is
shaped by power mechanisms, and thus certain things become true as
a result of how discourse is shaped by power. Wallace is right that
Foucault would disagree with the view that Truth is something with
pure objective value and can be absolute. For Foucault, truth is a
product of a discourse shaped by history, and the standards of truth
are constantly shifting based upon changing power structures. But, this
evolution of truth does not disrupt the ability of science and religion to
interact with one another. On the contrary, Foucault’s description
59 Ibid. pg. 21-22

Devin Gonier 39
opens up the ability for dialogue to occur. By empowering marginalized
voices, postmodern medicine aims at making the contemporary
discourse open to other less powerful explanations. Thus, the attempt
is not to argue that either biomedicine is True in an objective and non-
socially constructed sense or that religious claims are true in a
transcendental sense. But, postmodern medicine aims at creating
dialogue between different power structures by leveling the playing
field. One of the ways that this is possible is by flagging the moments
in our discourse that have become dominated by a particular
episteme. By bringing attention to these hegemonic epistemologies
within our discourse, the healthcare system can recognize the ways in
which it marginalizes other ways of thinking about and healing the
body.
Finally, Wallace suggests that Postmodernism emphasizes
aesthetics as the primary mechanism for determining belief. In other
words, a person chooses to believe a Buddhist principle or a scientific
principle, because it has a subjective appeal to them. A belief is
aesthetically chosen, when it lacks an objective basis, and is chosen
from a personal connection to an idea or belief that an idea is beautiful
or personally meaningful. This is very reminiscent of Dacher’s Personal
Authenticity principle. Postmodernism would support the autonomy of
the patient in choosing the best type of medicine for their treatment. In
many cases this is an aesthetic choice. If a person is a fundamentalist

Devin Gonier 40
Christian, then they might find trouble with the underlying Buddhist
principles within Tibetan medicine. Or if a different person is looking for
a type of healing that involves spirituality, energy, and consciousness
they might seek out Tibetan medicine or Reiki healing, because it
offers them the mechanisms of healing that are consistent with their
beliefs and would best provide them with the necessary confidence to
achieve health.60 In this way postmodern medicine would emphasize a
certain aesthetic choice of the patient – but this choice assumes that
the patient is well informed about the advantages and disadvantages
of various systems of healing (a knowledge that will continue to grow
for the everyday person).
Wallace’s criticism is very poignant. But, many of his criticisms
seem specific to Jackson’s postmodernism, and certainly are not very
applicable to the characteristics pointed out by Morris, Dacher and
Gray. The few that are applicable seen under a different light are not
really that troublesome. There is no perfect system for conceptualizing
the relationship between Tibetan medicine and biomedicine within the
U.S. healthcare system; there will always be criticisms, but there is still
great potential for postmodern medicine to help bring balance to the
U.S. healthcare system. In order to establish balance there has to be
recognition of the imbalances within the system already, and so it is
60 It is well known that confidence in recovering from illness plays a

big part in the effectiveness of treatment. Typically this is called
psychosomatic healing, and it will be discussed more thoroughly later
on.
Devin Gonier 41
necessary to explore the elements of biomedicine that have become
problematic.
Deconstructive Postmodern Medicine and Biomedicine
Biomedicine has saved and extended the lives of countless
individuals over the past few centuries. Scientific advancements made
by brilliant physicians and laboratory workers have revolutionized the
ways in which we treat illness and cure those who are suffering. Any
critique of biomedicine ought to be prefaced with the
acknowledgement that biomedicine has done a great service to the
advancement of health throughout the world.
When people speak of the U.S. healthcare system, they are
typically referring to biomedical treatment. On the contrary, healthcare
refers to a much broader system of health that includes not just the
primary biomedical treatment, but non-biomedical treatment as well
that may be considered alternative, complementary, or integrative. So,
when discussing the future of healthcare, and what it will take to make
that healthcare the best model possible it is important to look at the
entire spectrum of health and not just biomedicine. In order to address
the broader question of healthcare, this section will evaluate those
aspects of biomedicine that could potentially be greatly improved by
other systems of healing.
The criticisms addressed in this section are well known by many

Devin Gonier 42
physicians, and some actively, and sometimes very successfully, try
and solve these problems. A diverse healthcare system could provide
different epistemologies for healing. Like two puzzle pieces fitting
together, one epistemological disadvantage of biomedicine might be
an advantage for Tibetan medicine, and vice versa. The only way to
truly compensate for fundamental problems with biomedicine is to
allow other systems of healing to function along side biomedicine.
Drawing mostly upon postmodern medicine thinkers like David Morris,
this section will outline three main criticisms of biomedicine:
biomedicine is reductive, dualistic, and mechanistic.
Biomedicine is Reductive
What is meant by reductive here? George Engel61 defines
reductionism within the context of medicine as, “the philosophic view
that complex phenomena are ultimately derived from a single primary
principle.”62 This view is typically juxtaposed to holistic medicine. Tom
Dummer characterizes Tibetan medicine as holistic in his book Tibetan
Medicine and Other Holistic Healthcare Systems. He defines holistic as
the “understanding of reality, in terms of integrated wholes whose
properties cannot be reduced to those of smaller units.”63 This
61 George L. Engel is a psychiatrist in America best known for his

creation of the biopsychosocial model. He has spent most of his career
at the University of Rochester Medical Center.
62 GL. Engel, "The Need for a New Medical Model." Science 196
(1977): 131
63 Thomas G. Dummer, Tibetan Medicine and Other Health-Care
Devin Gonier 43
difference between holistic ways of looking at medicine and reductive
ways of analyzing medicine might make more sense when one
understands its cultural origins. Pre-Socratic philosophers in the West
like Heraclitus believed all of nature could be reduced to fire, and
Thales believed all of existence was some manifestation of water. In
fact, these thinkers were among many pre-Socratics that tried to find
the ultimate essence of existence by reducing the whole down to its
most essential part or parts. So, from the very beginning of Western
philosophy we find the roots of what can best be described as
reductionism. This became a major foundation for most of modern
science.
George Engel offers one very specific starting point for
reductionism in Western Medicine. According to Engel, five centuries
ago there was one very critical “concession of established Christian
orthodoxy to permit dissection of the human body.” The Church
allowed scientists to examine the body through autopsy on the sole
condition that these scientists do not involve the mind in their
investigation. The reasoning was that the mind and soul are subject
areas that belong to the Church. This beginning point was combined
with analytic philosophers like Descartes and scientists like Newton
and Galileo, who believed that investigations could be “resolved into
isolable causal chains or units, from which it was assumed that the
Systems. London: Routledge, 1988. 127

Devin Gonier 44
whole could be understood, both materially and conceptually, by
reconstructing the parts.”64 Thus, the doctrine of the Church and the
scientists of the time both moved biomedicine in the direction of
viewing the “body as a machine, of disease as the consequence of the
breakdown of the machine, and of the doctors task as the repairer of
the machine.”65 It was from these roots that reductionism was able to
gain such a strong foothold within medicine. Foucault might look at
these events and argue that they played an important part in changing
or shaping the power dynamic of medical discourse so that biomedical
doctors evaluates the body in a way that is distinct from the mind and
can be analyzed through reductive techniques.
This “narrow approach” was no doubt a great success, but
because it has been restricted to this approach alone, certain problems
have inevitably followed. 66

Many of the problems of allopathic67
medicine can be balanced by emphasizing holistic epistemologies for
healing in the U.S. healthcare system so that they can become more
popular. There are some limitations that exclusive allopathic medicine
creates. A holistic and allopathic approach will be compared.
1. Preventative Treatment vs. Fixing the Problem.
(1977): 131
65 Ibid. 132
66 Ibid. 132
67 For the criticism of reductionism specifically, this paper will use the
term allopathicmedicine, since some forms of medicine like osteopathy
might be considered biomedical but not reductive.
Devin Gonier 45
One primary difference between allopathic and holistic medicine is
the difference between preventative and immediate treatment.
Allopathic medicine is less effective at preventing future illness, but is
exceptional at treating problems as they arise especially during
emergencies; holistic medicine’s like Tibetan medicine are not well
known for emergency care, but demonstrate great success at
promoting long term health and treatment of chronic diseases. Dr.
Dorje, a Tibetan Amch at the Men Tsee Khang in Dharamsala,68 helped
illustrate the difference between preventative treatment and
immediate treatment by using an analogy of a pipe. Imagine for a
minute you have a pipe that looks like so:
WATER
The pipe is a representation of the body. In order to have a healthy
pipe, water must effectively be transported from one place to another.
The water is a representation of the various factors involved in the
maintenance of health, such as diet, lifestyle, and environment.
WATER XXXXX No Water
Then, there is a problem. The pipe is now diseased and has a clog. At
this point there are two main ways to deal with this infection. The first
way is to find the clog and remove it. This would be akin to surgery or
strong medicine.
68 An interview with Dr. Dorje.

Devin Gonier 46
Water XXX
Water
Once the clog or disease is removed, and there are no longer any
remnants of the infection it appears as if our pipe is healthy again. But,
it isn’t long before a similar type of problem manifests in an entirely
different way.
Water XXXX
At this point we might recognize that there is something wrong with
the whole system. Rather than remove the specific dysfunction by way
of treating the symptoms it would be better to understand what is
unhealthy about the system holistically. In other words, fixing the clog
metaphorically represents isolating and treating symptoms of a
specific dysfunction, rather than approaching the problem by
attempting to disrupt the root cause for the problems or clogs in the
first place. For instance, we might analyze the water, representing the
many factors that are involved in the maintenance of both subjective
and objective health like diet, exercise, emotional stability, etc. in
order to see if it is the source of clog or infection. Occasionally, it might
be discovered that the water is in fact filled with mud and dirt, and
Devin Gonier 47
longer-term adjustments to diet and other supplementary treatment
might prevent future illnesses from arising. If we fix the system itself
and focus on preventing future clogs by cleaning the source (i.e. the
water) then it wont be necessary to make invasive treatments on the
pipe to clean out every clog. Holistically speaking it would look like
this:
WATER
Allopathic medicine tends to focus on the treatment of symptoms, but
holistic medicine focuses on root causes for problems of the entire
system. As one anthropologist notes, we need to fill the gap. Holistic
medicines like “Tibetan medicine look for underlying patterns of
imbalance that may have systemic symptoms in the body emerging in
different places at different points in time. In contrast, biomedicine
[allopathic biomedicine] tends to focus on the disease as an isolated
phenomenon that can be targeted for intervention as if it were free
standing in the body and frozen in time (or over time), preferably as an
acute disorder (though not always).” 69
Holistic medicine acknowledges that bacteria and viral infections
are more likely to affect those who have a weakened body on a holistic
level. Maintaining the patients health consistently is just as important,
69 Vincanne Adams, “Randomized Controlled Crime: Postcolonial

Sciences in Alternative Medicine Research.” Social Studies of Science,
Vol. 32, No. 5/6 (Oct. - Dec., 2002). JSTOR. Sage Productions, 2002:
671
Devin Gonier 48
if not more important, than identifying the bacterial or viral source of
an illness. Mary Coddington in her book In Search of the Healing
Energy notes that,
Traditional medicine (conventional medicine) adheres, by

and large, to the germ theory of disease. The holistic
healer, although he recognizes that bacterial or viral
infection is present during illness, is apt to postulate that
germs alone do not cause disease but move in only when
the individual is in a poor state of health with weakened
powers of resistance. It is the holistic doctors goal to
maintain his patients in a stable condition of physical well-
being.70
Thus, reductive medicine might serve effective and important in the
quick fix problems of medicine, and in the curing of emergency or one-
time problem illnesses, but it ultimately fails at the long-term picture of
health and well-being. By not providing a solid foundation for health in
general, allopathic biomedicine does not ensure the prevention of
illnesses to come. Part of the reason for the difficulty in treating long-
term illnesses stems from the fact that allopathic medicine treats
illness by identifying the singular source for a disease rather than
understanding the illness to be the result of a multiplicity of causes
that interact with one another.
2. Multiple Causation vs. Single Causation
When analyzing the body as a whole there is almost never one
single cause to an illness. But, when the approach to medicine is
reductive the opposite is the case. Holistic medicines like Tibetan
70 Mary Coddington, In search of the Healing Energy. New York:

Destiny Books, 1983: 169
Devin Gonier 49
medicine believe the body is constantly changing and each imbalance
leads to other imbalances in the future until the body is temporarily
changed to resolve back into harmony. There is never a single cause in
Tibetan medicine for an illness, because an illness may be caused
karmically, (i.e. as a consequence from an action in this or a previous
lifetime) from an improper diet, an infection, or any combination of
these things. In Tibetan medicine, illness is never an isolated incident,
it is always something that has multiple causes and will ultimately
become the cause of some future shift in balance of the body. This is
because, as Dr. Ivette Vargas notes, “Tibetan medicine focuses on the
occurrence of disease as a particular event (an imbalance that may
lead to other imbalances) and that such imbalances may have multiple
causes. This is clearly in opposition to Western biomedical approaches,
which focus on diseases as generic entities, which must therefore have
‘a’ cause.”71
With a reductive approach, if a patient claims to be having liver
problems, then a doctor would most likely focus almost exclusively on
the liver. But from a holistic approach this doesn’t work. A liver
problem is a sign that there is a greater imbalance in the body. So, for
a holistic practitioner it might be just as valuable to analyze the eye or
71 Ivette Vargas, "Tibetan Medicine Revisited in the West: Notes on the

Integrative Efforts and Transformative Processes Occurring in
Massachusetts, USA." Laurent Pordie, ed. Tibetan Medicine in the
Contemporary World: Global Politics of Medical Knowledge and
Practice. London: Routledge, 2008: 224
Devin Gonier 50
the stomach to see all the possible causes and effects in the entire
body associated with that liver problem. It might seem like a random
choice for a doctor to analyze the stomach based upon a liver problem,
but because of the nature of a holistic approach doctors are trained to
understand in great detail the relationship between the different parts
of the body so as to have a greater picture of the whole. They thus are
more intuitive in their abilities to understand causality within the body.
By understanding how the liver affects other functions in the body as a
whole, a holistic doctor should be able to locate the root causes rather
than the immediate cause and by doing so will not only solve the
immediate problem but prevent future problems from occurring.
Cartesian Dualism, Physicalism, and the Importance of the Mind in
Healing the Body
As was mentioned briefly earlier, Descartes has had a profound
impact on the way Westerners think generally, and how doctors think
specifically. Rene Descartes argued that the mind and body were
functionally two different types of substances. For Descartes, the body
is essentially a machine, which follows basic laws of physics and can
be described as completely material. In contrast to this the mind is
non-material, does not follow the laws of physics, and can control the
machine via the pineal gland (which was not well understood at the
time, and which he considered the seat of the soul.). Obviously,

Devin Gonier 51
biomedicine has come along way from believing that the body is
controlled by the mind through the workings of the pineal gland.
Nonetheless, biomedicine has not come a long way from the more
basic philosophy that Descartes proposed. Biomedicine still works off
the assumption that the body is a machine and the doctor’s role is to
“repair that machine.”72 After Descartes, further advancements in
biomedicine entrenched this idea as well:
Technological advances (e.g., microscopy, the

stethoscope, the blood pressure cuff, and refined
surgical techniques) demonstrated a cellular world that
seemed far apart from the world of belief and emotion.
The discovery of bacteria and, later, antibiotics further
dispelled the notion of belief influencing health. Fixing
or curing an illness became a matter of science (i.e.,
technology) and took precedence over, not a place
beside, healing of the soul. As medicine separated the
mind and the body, scientists of the mind (neurologists)
formulated concepts, such as the unconscious,
emotional impulses, and cognitive delusions, that
solidified the perception that diseases of the mind were
not "real," that is, not based in physiology and
biochemistry.73
Furthermore, biomedicine makes the distinction between an
illness and a disease. Illness represents the subjective impression
of the patient that there is something wrong with the body,
whereas disease represents an objective observable problem with
the body. Morris explains that “What the patient reports is
subjective (and untrustworthy), what the lab reports is objective
(1977): 132
73 No Author. “Mind-Body Medicine an Overview.” National Center for
Complementary and Alternative Medicine. www.nccam.nih.gov
Devin Gonier 52
(and true).”74 This distinction makes it easy for doctors to discard
the more subjective and mental aspects of illness, because they
are irrelevant in the curing of “disease.” These advancements in
medicine combined with the philosophical influence of Descartes
changed the course of biomedicine to become completely
centered on the body.
Once again, this provides an interesting contrast to Tibetan
medicine, which works off of the principle that the mind is an essential
part of the healing process. Tibetan amchis consider factors involving
lifestyle and emotional stability in the diagnosis of disease, and
because Tibetan medicine is so intricately linked to Tibetan Buddhism
many of the fundamental principles used to understand and diagnose
disease come from the Buddhist conception of the mind. In this sense
Tibetan medicine represents what Morris advocates when he refers to
postmodern illness. For Morris, this transition implies “a shift,
incomplete and ongoing, in which the patient, no longer merely a
bundle of symptoms reported by an unreliable, subjective ego,
emerges at moments as a valued participant in the medical process of
diagnosis and treatment. In this shift disease and illness also undergo
change.”75 This difference in thinking about the role of the mind in
healing also affects the way in which Tibetan medicine and

75 Ibid. Pg. 39
Devin Gonier 53
biomedicine understand psychosomatic healing.
1. Psychosomatic Healing
Most Western doctors when doing laboratory tests on medicines
acknowledge psychosomatic healing. This is the reason why double
blind test procedures can be effective, because it is important,
according to a western biomedical model, to understand the effects of
the medicine excluding the mental effects of the patient believing in
the effectiveness of a medicine, as is sometimes the case with
placebos. In western biomedicine psychosomatic healing essentially
represents a variable to avoid; something that can negatively affect
the results of an experiment meant to discover the effectiveness of a
medicine. Vincanne Adams notes that “the idea of ‘psychosomatic’ as
it is understood today in the Western context is not appropriate to
apply in Tibetan.” The reason such a distinction does not exist is
because in Tibetan medicine and Tibetan culture more generally, the
body and the mind are not understood as parallel processes that have
no affect on one another. In Tibetan medicine if a person is healed and
the only explanation for that healing is a mental one, then the healing
was successful. In Tibetan medicine focusing on the mind is an
invaluable approach to healing the body. Cure the mind and you will
cure the body. In a western context, the mind is irrelevant; one simply
cures the body.

Devin Gonier 54
Recent research demonstrates some of the significant ways in
which the mind has power over the body. For example, one very
obvious intersection between the mind and the body is the relationship
between mental stress and back pain. In fact, a study involving 48,000
men in the Swedish army concluded, “Job stress was related to
emotional distress, and this distress was directly related to clinic visits
for back pain. The more emotional distress a soldier had, the more
return visits to the clinic it took to solve the back pain.”76 One could
easily find many more cases where the mind played a surprisingly
significant role in the healing process.77 One reason for why there is
more emphasis on the mind in Tibetan medicine is that it draws heavily
upon Buddhist ways of understanding the mind. This difference in
thinking draws upon an important distinction between 1st person and
3rd person observation in the quest for knowledge.
2. !st Person vs. 3rd Person Observation
The Dalai Lama explained one very interesting cultural difference
between the way the Western scientific system has developed and the
way in which Buddhist thought has developed over time.78 He
76 "John Hopkins Health Alert: How to Cope with Stress - Induced Back
Pain." Back Pain and Osteoporosis (2007). John Hopkins Health Alert.
John Hopkins Medicine.
<http://www.johnshopkinshealthalerts.com/alerts/back_pain_osteoporo
sis/JohnsHopkinsHealthAlertsBackPainOsteoporosis_1449-1.html>.
77 Ibid
78 H.H. Dalai Lama. The Universe in a Single Atom: The convergence of
Science and Morality. TBWA Morgan Rd. Books, 2005
Devin Gonier 55
suggests that there are two ways to understand any object of
knowledge: a 1st person perspective observation and a 3rd person
perspective observation. The 3rd person perspective most clearly
represents the Western way of knowing. This perspective dictates that
there is an object that is to be observed following a strict procedure of
inductive reasoning in order to come to certain conclusions about that
object. With the 1st person observation technique, a person follows
procedures developed by previous masters to observe themselves in
order to understand deeper realizations about their own existence and
human nature more generally. The West often disregards this
perspective because it is considered “subjective.” However, notice that
this subjectivity/objectivity distinction is precisely the division between
illness and disease and the mind and the body. The Dalai Lama
suggests that both procedures for observing fail and succeed, and the
best way to learn about the body and Human nature is to combine
both methods. Because of its Cartesian influences, biomedicine “gives
greatest value to knowledge that can be verified as objective.”79
The 1st person observational perspective coming from Buddhist
and Hindu approaches to meditation have surprised many Western
scientists. Dr. Benson once performed an experiment with the
permission of the Dalai Lama to observe gtum mo meditation and its
effect on the body. What most surprised the scientist was one

Devin Gonier 56
particular event in which a group of highly skilled monks were able to
completely dry wet sheets in freezing temperatures by increasing their
body temperature through meditation. These exceeded the doctor’s
expectations, and surprised most Western scientists, as no
physiological explanation seemed to make sense. In this particular
circumstance it was nothing other than a group of very skilled
practitioners using their minds to influence their bodies. The problem
with these studies for many Western scientists is that there is no way
to internally observe, beyond the physical effects of increased body
temperature, what is happening with the meditators; the type of
tantric energy being harnessed was ultimately not scientifically
provable. However, there can
“be little doubt that this energy – call it orgone, ch’I,

mana, prana, Innate, or vital force- does indeed
exist. It is, after all presently being harnessed, or
released from blockage, by the various therapies of
acupuncture, homeopathy, bioenenergetics,
kinesiology, hypnosis, chiropractic, yoga, psychic
healing, biofeedback and others. The healing energy
can be harnessed, yes, but still not scientifically
measured.” 80
The Dalai Lama’s wisdom about combining different approaches to
knowing can be quite useful to the advancement of healthcare in the
U.S. In fact his recommended approach returns one previous criticism
Wallace had of Foucault and absolute truth. The Dalai Lama suggests
that in the different discourses on Buddhism and science there are
80 David B. Morris, In Search of the Healing Energy. New York: Destiny

Books, 1983:169-170
Devin Gonier 57
different epistemologies for understanding ideas. Thus, the possibilities
for science to interact with Buddhism are largely shaped by socially
produced power structures that construct what is deemed to be
acceptable standards for knowing something. Biomedicine’s physicalist
approach is the result of its reductive framework, and this approach
limits its potential for healing because it is too restrictive in its view of
the minds potential. Combining the 3rd person technique and the 1st
person technique in an effective way is precisely what is meant by
multi dimensional realism as an advocacy of postmodern medicine
mentioned earlier. Only by harnessing the power of subjective and
objective observation can the greatest potential for success be
achieved.
Another critique is that biomedicine is mechanistic in two ways.
First, it lacks intuitive attention to the individual patient and it is
formulaic in the way in which medicine is prescribed to patients.
Secondly, biomedicine is mechanistic in the way doctors are taught to
be empathetic towards the patient.
1. Intuition, Mapping the Body, and Healing the Specific Illness
Traditionally, doctors are taught that certain medicines
correspond to certain diseases. These diseases have certain signs,
which can be apparent in the symptoms of the patients or through lab

Devin Gonier 58
results. Regardless of the individual person, a disease is treated
through medication or therapy that has been discovered to be
effective through research and development. Based upon their
knowledge of how to treat the disease they prescribe the appropriate
treatment. The only reason the doctor would avoid one medicine over
another medicine in this situation is if the patient is allergic to some of
the medication, or if one medicine has a better record from clinical
trials, or if that medicine would negatively counteract with other
medicines taken by the patient. To most Westerners this experience
seems fairly typical and not that problematic. Biomedicine has a
greater emphasis on curing the specific disease for the average person
than curing the disease relative to the specific person.
During an interview with Dr. Dorje at the Men Tsee Khang in
Dharmsala, India, he said that Tibetan medicine places great emphasis
on what he called mapping the body. This refers to a very deep
examination of the patient (especially those patients with chronic
illness) in which the body type is classified according to the most
dominant humor. In Tibetan medicine, each body has a certain humor
(Phlegm, Bile, or Wind or a combination like Phlegm-Bile) that
predominates (there are seven possible variations of body type), but
this predominance changes throughout the course of life depending on
a number of factors including the age of the person. The first task of an
amchi mapping the body is to identify the body type of the patient.
Devin Gonier 59
After this, an amchi must evaluate the season, time of day,
psychological influences (such as troubles at home), diet, and lifestyle.
Each one of these factors helps the doctor understand what the
body/mind is going through at the time of the illness. After evaluating
the patient, then the doctor tries to understand where the imbalance is
in the body, and what might be causing the imbalance. This is where
Tibetan medicine and biomedicine go down different paths. A patient
with a biomedicine doctor displaying X symptoms will be treated with Y
medicine, but in Tibetan medicine X symptoms don’t necessarily imply
a Y treatment; it all depends upon the patient and his mind/body
condition. Vincanne Adams gives a good example of this type of
approach,
Tibetan medicine classifies diseases according to the

humoral constitution of the patient and its relationship to
other simultaneous disorders, not on the basis of disease
resemblances between patients only. For example, a person
with a ‘blood’ growth in the uterus may be diagnosed as
having the growth because of weak ‘downward expelling
winds’ accompanied by strong ‘bile’ energy. Another patient
with a ‘growth in the uterus’ that looks just like the first
patient in an ultrasound diagnosis, will be diagnosed as
having a ‘flesh’ growth from an overly strong ‘phlegm’
presence accompanied by ‘strong winds.’ Thus, two
patients with the same biomedical disease can be seen as
having different Tibetan diseases.” But, even if the patients
are identified with the same Tibetan disease, they may be
diagnosed with different etiological pathways, and so
needing different treatments.81

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Devin Gonier 60
This difference in methodology for treating a patient means that an
amchi has more room to be intuitive in the treatment of a patient. By
following his or her experience and training each diagnosis is specific
to not only the illness, but also the body/mind of the patient. It is
exactly because of this approach that Tibetan medicine has faced
many difficulties in the process of getting medicines legalized and sold
throughout the U.S. The NCCAM follows strict procedures for
determining the effectiveness of medicine, following biomedical
guidelines. Understanding the specific characteristics of the patient’s
body includes trying to understand the patient’s life circumstances and
emotional well-being. This approach helps to build a strong doctor-
patient relationship that promotes empathy over more mechanistic
and general procedures to treating illness that are characteristic of
biomedicine.
2. Empathy
Empathy within the context of biomedicine has a long history of
complications and change. How a doctor relates to a patient can often
be a delicate matter. In fact, “empathy in effect, has no fixed meaning
or value in the history of medicine. It is a contested term whose
historical complications its opponents and proponents silently ask us to
forget.”82 The trouble from a biomedical perspective is that doctors
82 David B. Morris, "How to Speak Postmodern: Medicine, Illness, and

Cultural Change." The Hastings Counter Report. Vol. 30 No. 6 (Nov-
Dec. 2000) JSTOR. Hastings Center, 2000: pg. 10
Devin Gonier 61
may become too attached to their patient’s suffering, and are unable
to carry out necessary functions that would effectively heal the person.
Lorraine Code83, author or Rhetorical Spaces, explains that “empathy is
a thoroughly double edged phenomenon: its expression is not an
unqualified good. Hence it is vital that its would be advocates develop
a self critical politics of empathy, to keep them as cognizant of its
pitfalls as they may be of its promise.”84 Often times, genuine empathy
is discouraged or repressed. Rafael Campo in his work The Desire to
Heal discusses some of the difficulties he experienced while training to
be a physician. His work dealt primarily with AIDS, and he developed
strong connections with his patients. In fact, these feelings were strong
enough to lead to “an anonymous hand-scrawled note placed in my
evaluation file saying that I had ‘problems with identifying too strongly
with my patients” and that I had a “tendency to let my emotions get in
the way of patient care.”85
Empathy is not considered useless in biomedical practice, but
the way in which the biomedical community acknowledges and
promotes empathy is ultimately artificial. It understands empathy as
something of instrumental value. Being able to make the patient feel
83 Lorraine Code. Rhetorical Spaces. New York, NY: Routledge,

1995.pg.121
84 Lorraine Code is Distinguished Research Professor in the
Department of Philosophy at York University in Toronto, Canada and a
Fellow of the Royal Society of Canada.
85 David B. Morris, "How to Speak Postmodern: Medicine, Illness, and
Cultural Change." The Hastings Counter Report. Vol. 30 No. 6 (Nov-
Dec. 2000) JSTOR. Hastings Center, 2000: pg. 11
Devin Gonier 62
that they are cared for, or that the physician empathizes with them,
can lead them to share information and facilitate their own healing in a
more effective way. In the biomedical community
it is far safer to focus on behaviors that reduce empathy to

a practiced smile, a firm handshake, and a glance at the
wristwatch to let eighteen seconds pass before
interruption. Lost is the chance for a human encounter
that, as for Campo, allows healers to confront, and if they
are lucky, to learn from their own vulnerability and
unacknowledged brokenness.86
Thus, empathy exists in the biomedical community, but it is
encouraged to exist only as an artificial tool to facilitate treatment.
Part of the problem is that biomedicine focuses on diagnoses and
mechanistic elements of applying biomedical principles to treatment.
Thus, Morris notes that “it should not seem a surprise that biomedicine
has mostly ignored suffering in favor of problems – not always equally
pressing- where the boundaries are less vague and the complications
more responsive to innovations in technique and in pharmacology.”87
One of the primary arguments coming from narrative medicine
thinkers like Rita Charon is that biomedicine is unempathetic, because
it fails to relate and empathize with the narrative of struggle that the
patient undergoes throughout the path to health. Rita Charon explains
that
Despite such impressive technical progress, doctors often

lack the human capacities to recognize the plights of their
86 Ibid. pg. 11
University of California P, 2000.pg. 193
Devin Gonier 63
patients, to extend empathy toward those who suffer, and

to join honestly and courageously with patients in their
struggles toward recovery, with chronic illness, or in facing
death. Patients lament that their doctors don’t listen to
them or that they seem indifferent to their suffering.
Fidelity and constancy seem to have become casualties of
the cost-conscious bureaucratic marketplace. Instead of
being accompanied through the uncertainties and
indignities of illness by a trusted guide who knows them,
patients find that they are referred from one specialist and
on procedure to another, perhaps receiving technically
adequate care but being abandoned with the
consequences and the dread of illness.88
This highly mechanized process of biomedicine creates a great
disparity between the patient’s experience and the doctor’s
experience in treating them.
Despite Morris’ criticism of artificial empathy in
biomedicine, he suggests that genuine empathy might be
impossible. Exploring the writings of Levinas, Morris suggests,
“The assumption that we can feel someone else’s feeling is for
Levinas an exercise in self-deception that transforms eros into an
instrument of power.”89 In other words, genuine empathy is
impossible, since no human can ever fully relate to another
human in the way that the concept empathy requires. Part of the
problem is a lack of clarity on what exactly defines empathy, and
how a doctor experiences and utilizes empathy. It doesn’t
become surprising then, that in a western context authors like
88 Rita Charon, Narrative Medicine: Honoring the Stories of Illness.

Oxford: Oxford UP, 2006: 3
Devin Gonier 64
Levinas question the concept of empathy as even a possibility.
However, Levinas’ criticism of empathy is specific to ways in
which empathy is understood in the west. Tibetan medicine
utilizes the Buddhist idea of bodhicitta, which is one way of
understanding empathy, in its treatment of illness.
Bodhicitta in Tibetan Medicine
Bodhicitta literally translates to the mind of the Buddha, or
aspiration of the Buddha (however there are many other complex ways
of translating this Sanskrit word into English). This aspiration for
enlightenment is not selfish, because one struggles to achieve greater
power and insight in order to help those who suffer. Bodhicitta values
the other before the self, and seeks not necessarily to understand the
perception of the other – as Levinas would attempt to conceptualize
empathy – but attempts to develop a deep sense of compassion
towards curing the others pain. Bodhicitta transcendently invokes
forces that are beyond the abilities of the doctor, and the feeling of
empathy that it generates is equally divided among all sentient beings,
whether they are mother or enemy. Marion L. Matics, a commentator
and translator of Santideva’s Bodhicaryavatara writes, “Bodhicitta (like
Citta) partakes of a quasi-universal aspect, because…it is a force let
loose in the universe to work for the good of all.”90 Lama Zopa
90 Marion L. Matics, Entering the Path of Enlightenment. London:

Macmillian. (BCA Trsl) 1970. pg. 34
Devin Gonier 65
Rinpoche argues from the Tibetan Nyingma tradition that when this
transcendent force is used by healers and patients it “is the best
medicine for the mind and for the body.”91 Thus, many amchi’s that try
and incorporate Buddhist principles into their practice believe that
bodhicitta is not only a virtue, but that it can also invoke or draw upon
healing sources like the Medicine Buddha that are outside of Samsara.
There is nothing about the practice of Tibetan medicine that
structurally requires bodhicitta, but many amchi’s utilize the Buddhist
idea of bodhicitta in their medical practice as an extension of their
religious practice. In fact, in every interview in Dharamsala each amchi
explained that bodhicitta is an essential aspect of practicing Tibetan
medicine. Bodhicitta is not something that is achieved without effort; it
is something that many Tibetan amchi’s try to develop, which is quite
different from the repression of genuine feelings of empathy in
biomedicine. This specific rendition of compassion – far more complex
than the western word empathy- could be very valuable within a
western context in facilitating a connection between patient and doctor
that is genuine.
Based on the previous observations, the main argument of this
paper is that postmodern medicine creates space for religious healing
systems like Tibetan medicine to function effectively in the U.S. One
way that postmodern medicine can be productive in modern American
91 Lama Zopa Rinpoche. Ultimate Healing: The Power of Compassion.

Boston: Wisdom Publications, 2001. Pg. 18
Devin Gonier 66
healthcare discourse is by minimizing the power scientific materialism
and scientific fundamentalism have on healing in the U.S.
Scientific Materialism and the Development of an Areligious
Healing Metanarrative
Scientific materialism asserts that the universe, consciousness,
and most questions that are especially meaningful for religions can be
entirely explained by empirical observation. The position of scientific
materialism when completely accepted presents radical problems for
religious statements of subjectivity and the immaterial. Medicine has
come to embody the principles of scientific materialism, and as a result
a metanarrative within U.S. society has developed where religion and
theories which make transcendent claims that are irreducible to
scientific principles have no place in the role of healing. Thus, when
healing systems like Tibetan medicine that utilize subjective methods
of the mind or incorporate religious ideals in their practice of healing
are introduced to the U.S. health system they face hostility. A large
part of this hostility happens before medicines like Tibetan medicine
have the opportunity to be introduced to the society by government
organizations like the NCCAM. The overwhelming power of scientific
materialism within the healthcare discourse has transformed the way
people conceive of their body, how they treat their ill body, and how
they conceive of what is true of their body.
Scientific materialism can be understood as an extension of the

Devin Gonier 67
epistemological view called logical positivism. For logical positivists like
Rudolf Carnap92 concepts like God and love are only emotive
expressions, and all religious and philosophical views that cannot be
empirically verified do not serve a purpose in advancing our knowledge
of the world. Therefore, academic systems like religion, ethics, and
metaphysics embody meaningless statements, and only represent
attitudes of the people who discuss them.
This view is in radical contrast to Postmodernism, which asserts
an entirely different understanding of experience and language. As
Zygmunt Bauman notes in his article “Postmodern Religion?”
Postmodern mind…accepts the fact that all too often

experience spills out of the verbal cages in which one
would wish to hold it, that there are things of which one
should keep silent since one cannot speak of them, and
that the ineffable is as much an integral part of the human
mode of being-in the world as is the linguistic net in which
one tries (in vain, as it happens, though no less vigorously
for that reason) to catch it.93
From this one can conclude that postmodernism and logical positivism
do two very opposite things. Whereas logical positivism tries to
eliminate certain linguistic statements and terms, because they cannot
be verified, postmodernism argues that experience is more complex
than language can articulate. So, whereas many scientific
92 See Rudolf Carnap, "The Elimination of Metaphysics Through Logical

Analysis of Language". In: A. J. Ayer, ed., Logical Positivism. Glencoe,
Ill.: The Free Press, pp. 60-81. Translation of Carnap 1931.
93 Zygmunt Bauman, "Postmodern Religion?" Religion, Modernity and
Postmodernity (Religion and Modernity). New York: Blackwell, 1998:1.
Language
anguage
but genuine
expresses
human tooVerifiable
experience
much thatislanguage that
ineffable, andcan
is meaningless, meaningfully
beyond
and must beexplain
it language reducedexperience
to statements that are verif
Human Experience Language
Devin Gonier 68
materialists94 will assert that the human experience can be reduced to
logical statements of neuroscience, postmodernism argues that not
only is such a reduction impossible, but human experience cannot
even be expressed through the mechanism of language.
Postmodernism Logical Positivism
This linguistic distinction is an important one to make, because it
demonstrates how postmodern medicine is aimed at expanding
healthcare discourse to include ideas that might not be empirically
verifiable, but still have the potential to save or improve lives.
Postmodern medicine therefore theoretically disrupts the
metanarrative of healing that asserts that ‘subjectivity cannot be an
agent in healing because subjectivity is an illusion – it is something
which is essentially organic matter or a collection of neurotransmitters
in the proper order.’ Postmodern medicine does not eliminate the
possibility of this interpretation; it simply eliminates its status as a
hegemonic metanarrative. Postmodern medicine views logical
94 More specific than scientific materialism is eliminative materialism.

Eliminative materialism refers to the view that all human experience
can be fully explained and understood through a completed
neuroscience.
Devin Gonier 69
positivism as just another coherent way of thinking about the world,
and not the only coherent way of thinking about the world. Therefore,
postmodern medicine can and by its nature does disrupt the
metanarrative of an exclusively scientific materialist medicine, by
expanding the possibilities of healing to include subjectivity and
consciousness in such a way that may not reduce to logical principles
or scientific understanding. Perhaps, one way to expand our healthcare
discourse is to begin finding successful models of integration that can
include both religious and secular modes of healing.
Integration, Globalized Tibetan Medicine, the NCCAM, and the
U.S.
Vincanne Adams separates two modes of integration. The first is
integration, which “in its best possible sense results in the sharing and
exchange of knowledge and practices”95 between two or more
healthcare systems. For example, Tibetan medicine incorporates
biomedical principles within its framework, and biomedicine
incorporates Tibetan medical principle within its framework. On the
other end of the spectrum is erasure, which is where one” healthcare
system eliminates another one “for the sake of incorporating the
other.” For example, biomedicine incorporates Tibetan medicines
95 Vincanne Adams, and F. F. Li. "Integration or Erasure: Modernization

at the Mentsikhang." Tibetan Medicine in the Contemporary World
Global Politics of Medical Knowledge and Practice (Needham Research
Institute). New York: Routledge, 2008: 109
Devin Gonier 70
pharmacopeias and other advantageous principles within the
biomedical framework, such that there is less demand to practice
exclusively Tibetan medical principles and less demand for patients to
seek out Tibetan medicine.
Integrating two systems would be a sort of mutual growth in
which both systems acknowledge the autonomy and legitimacy of the
others epistemology. By integrating healthcare systems it is much
easier to adopt a heterogenous healthcare system that can prescribe
multiple types of treatments using multiple diagnostic procedures.
These procedures and treatments can significantly improve the
healthcare system more broadly because they allow for specialization
in certain areas specific to indigenous and foreign types of healing.
Integration is about adaptation and improvement of a healing system
in response to new ideas found in other systems of healing, but this
adaptation never compromises the core beliefs or epistemologies.
However, erasure functions in a way that would promote
homogenous globalization. It does this through the mechanisms of
capitalism. One of the greatest structures that can perpetuate erasure
within a capitalistic framework would be a legal barrier. As long as
legal barriers are in place medicines must undergo a validating process
within the hegemonic medical framework. If these legal restrictions are
too severe a foreign healing system will suffocate in a marketplace of
supply and demand, and the hegemonic healing system will benefit
Devin Gonier 71
from the foreign healing system by incorporating any research that can
be considered relevant or suitable to its hegemonic model of healing.
Most of the legal suffocation comes from the NCCAM. As
Vincanne Adams’ notes in her article, “Randomized Controlled Crime:
Postcolonial Sciences in Alternative Medicine Research” the NCCAM
carries out a number of biopolitical functions in the process of
validating certain types of medicines. As was mentioned earlier,
interest in alternative medicine has been growing very significantly
over the past few decades, making the role of the NCCAM more and
more important. As she notes, “The branch of NIH devoted to studies in
CAM had a 1993 budget of US $2 Million (it was then the office of
Alternative Medicine) and, by March of 2000, it was $68.7 million
dollars (as the National Center for complementary and alternative
Medicine NCCAM.”96 This organization’s function is to evaluate
alternative medicines in the U.S. and determine licensing qualification
and testing for foreign medicines that will be sold as treatment in the
U.S. However, in the act of evaluating what counts as “legitimate”
medicine, the NCCAM has to decide what counts as legitimate science,
and what counts as a cure to the disease based on a biomedical model.
The NCCAM presupposes a biomedical model in a number of
ways that Vicanne Adams outlines. The first, deals with the diagnostic

Vol. 32, No. 5/6 (Oct. - Dec., 2002). JSTOR. Sage Productions, 2002:668
Devin Gonier 72
techniques, which include both the identification of the illness based
upon its symptoms, and the etiology of that illness. This is important,
because Tibetan medicine functions on an entirely different
epistemology. Vincanne Adams explains that,
“starting with biomedical diseases results in a

disorganization of the Tibetan approach,
undermining the logic of its etiology and treatment
resources, and making it most likely that it will not
produce statistically successful outcomes. In the end,
medicines that cant show effectiveness in treating
biomedical diseases are considered a failure.
Practitioners who use them are at risk of accusations
of medical fraud.”97
Furthermore, Tibetan medicine’s diagnostic technique is
fundamentally different in how it evaluates the correct disorder of the
patient. In the Western system, the primary variables of determining
the disease are based on the symptoms of the patient. In Tibetan
medicine, one must not only understand the symptoms, but also
understand the body type of the patient. This means that where
biomedicine may say that one subject group has a distinct
illness/disease, Tibetan medicine will see different imbalances in
different patients of that group. As a result, taking a large category of
patients who all exhibit the conditions for a biomedical classification of
a disease will inhibit the potential for success of Tibetan medicine,
because some patients within the biomedical category might require
one type of medicine for their imbalance while another patient will
97 Ibid. Pg. 671

Devin Gonier 73
require another type of medicine for their specific imbalance. Like
trying to fit a square peg in a round hole, the system that qualifies
legal medicine presupposes a particular medical episteme, and thus
prevents or limits epistemologies that are significantly different. The
NCCAM would take a sample group all exhibiting symptoms of disease
X (as interpreted from a biomedical perspective) and then would
expect one medicine from Tibet to cure disease X. But, the problem is
that within group X, a Tibetan Amchi would diagnose people with
having X, Y, and Z imbalances (because of their specific body types),
and all the different imbalances would require different medication. So
to run an experiment where Tibetan medicine must treat a group X
(as identified by biomedicine) with treatment X, when the Tibetan
Amchi would diagnose patients in Group X with X, Y, and Z would
almost entirely eliminate the possibility for success.
NCCAM and Success of Treatment
Secondly, the NCCAM utilizes different standards of
determining whether or not the disease/illness is cured. For Tibetan
medicine, the permanent elimination of symptoms and the balancing
of the various humors constitute a healthy body. For biomedicine in
the case of bacterial illnesses and viruses, the elimination of the
bacteria (discovered as a result of lab testing) constitutes the
successful curing of a patient. In one trial in particular (a trial on a

Devin Gonier 74
group of HP positive patients) this was especially noticeable,
“The symptoms were eliminated, but the Hp was

not…Were the collections of symptoms named as the
set of some six disorders in Tibetan medicine, the
“disease” being studied? If so, then Tibetan medicine
cured them. Or was infection with Hp the disease,
therefore ongoing infection evidence that Tibetan
medicine ultimately did not work to cure these
patients…on the one hand “powa ching cha mu bu,”
along with several other ‘Tibetan diseases,” was
cured, but, when the disorder was called Hp, in the
terms of biomedicine, Tibetan medicines proved to
be ineffective.”98
This study is a good example of a situation in which data is simply
understood differently depending on the medical system being used.
Forcing Tibetan medicine to work entirely within a biomedical
diagnostic framework prevents Tibetan medicine from being able to
demonstrate its effectiveness and earn a higher legal status within the
U.S.
NCCAM and Architecture of Medicine
Finally, the way in which the medicine itself is constructed is
unique to the medical system being used. In Tibetan medicine it is
not uncommon for dozens of ingredients to be used in a single pill.
But, organizations like the NCCAM don’t acknowledge this
architecture, and prefer to focus on the effectiveness of single
98 Vincanne Adams and F. F. Li. "Integration or Erasure: Modernization

at the Mentsikhang." Tibetan Medicine in the Contemporary World
Global Politics of Medical Knowledge and Practice (Needham Research
Institute). New York: Routledge, 2008: 126
Devin Gonier 75
ingredients. This prevents the effectiveness of most Tibetan herbal
medicines; in order to be tested these herbal medicines must be
stripped of some of their most valuable components. “The RCT
method advocated by NCCAM allows for Investigational New Drug
Status for Tibetan medicines, but it also limits the number of drugs
and ingredients that can be tested in clinical trials… The model of
singular magic bullet drugs or treatments that can eliminate
identifiable acute diseases runs counter to the model of treatment for
diseases that are humorally-based and change as treatments
progress, requiring subtle re-combinations of sometimes over 60
ingredients and, for many patients, constantly shifting combinations
of different medicines.”99 This limitation on the number of ingredients
creates a huge barrier to Tibetan medicine entering into the U.S
healthcare system. Thus, some of the most valuable and potent
medicines, which carry a large number of ingredients, either must
become less potent or have no chance of ever even being tested in
the U.S.
All of these evaluations are ultimately standards that were
developed by an organization with political authority that organizes
its experiments on the presuppositions of a biomedical framework. In
other words, any other foreign medicine that is tested through the

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Devin Gonier 76
NCCAM must fit cleanly into a biomedical framework. But, for one
framework (i.e. the biomedical) to hold such sway over the legal
validation process for other types of medicines is a form of
biopolitical control meant to entrench certain ways of thinking about
the body and analyzing the body.
What Vincanne Adams suggests is that the NCCAM is making
biopolitical choices, such that it controls what qualifies as legitimate
conceptions of the body and the treatment of the body. The
consequence extends beyond the legal apparatus to the discourse on
the body and healthcare itself, and the government functionally
empowers biomedical assumptions over other power structures
within the discourse. All patients seeking treatment must conform to
certain standards set up by the NCCAM that specify to what extent a
physician can be considered liable for prescribing a medicine that
might be unsafe for a patient. Thus, discourse of the body is
produced by the NCCAM, because the validation process presupposes
a biomedical way of understanding the body, and this filtration
process limits the potential for other ways of healing the body. The
result is that biomedicine becomes what Engel calls the dominant
“folk model” for the body.100
What this ultimately means is that as long as this biopolitical
framework remains in place that entrenches biomedical principles as
(1977): 132
Devin Gonier 77
the only validating standard, then erasure is the only possibility for
Tibetan medicine in a Western context. In other words, Tibetan
medicine can only be practiced in the U.S. within a biomedical
framework and through a biomedical justification. In order to practice
Tibetan medicine one must receive a license in biomedicine first, and
any Tibetan medicine prescribed in the U.S. is considered a
supplement. Thus, to bring about a heterogeneous healthcare system
in the U.S., many of the procedures of the NCCAM will have to be
reconsidered so that they are more open to different medical
epistemologies. Only when this happens is it possible to have
integrative medicine in the U.S. that grants Tibetan medicine its own
autonomy in relation to biomedicine.
Most amchi’s interviewed during the process of research for this
project listed the greatest barrier to change as “recognition.” This
“recognition” will only be possible if there are avenues for Tibetan
medicine to demonstrate its effectiveness in terms of Tibetan
medicine. This will require cooperation and a framework like
postmodern medicine that supports a heterogeneous healthcare
system.
Conclusion: From the Theoretical Back to the Practical
In contemporary society, policy is such that biomedical principles
are reinforced and entrenched by government agencies whose job it is

Devin Gonier 78
to determine the legitimacy of alternative healing systems. Great
strides have been made in the past few decades in both academic
thought and in popular demand for new ways of thinking and healing
the body. This is largely a reflection of the shift in history from
modernity to postmodernity. However, despite a lack of insurance
coverage for most systems of healing outside of biomedicine, with the
exception of acupuncture and chiropractic treatment, demand has
increased and policy has not kept up with this ideological shift.
Organizations like the NCCAM, which utilize a very profound biopolitical
function, are still working within the ideology of modernity, and
continue to ingrain biomedical thinking. As was mentioned earlier it is
as if we are trying to fit a square peg in a round hole, where the peg
represents medicines like Tibetan medicine and the hole represents
the NCCAM. The advocacy of this thesis is that we should expand the
hole, so that it may incorporate different coherent models of thinking
about the body.
One of the problems with making this shift is the constitutional
status of religion and state in the U.S. To what extent can the state
legitimize religious principles used for healing? The problem is that not
legitimizing these principles is itself a position in affirmation of one
coherent model over another, namely a secular biomedical model.
Scientific materialism can be just as much a fundamentalism as any
religious fundamentalism. The scientist that refuses to evaluate claims

Devin Gonier 79
prima facie because they are religious or cannot be reduced to some
empirical verification principle is as fundamentalist in epistemology as
the religious zealot who refuses to acknowledge scientific claims. The
position of having no position in terms of religion and healing is
impossible, since secularizing medicine is a position of biopolitical
hostility towards religious ways of conceiving of the body. The
argument is not that the government should necessarily endorse
religious healing; rather it should expand the definition of healing so
that it allows for other coherent models, which include religious
principles, to have a legitimized avenue to heal within society.
Future Possibilities
What would such a society look like where scientific models exist
side by side with other models that are inspired or influenced by
religious teachings? David Cohen explains the Dalai Lama’s position at
a conference on religion and science,
Scientific inquiry has a shadow aspect that manifests as

dominance, exploitation, subjugation, and arrogant
imposition of authority. The opposite involves a posture of
humility and surrender in the face of what is unknown and
what is given in stewardship. In his keynote the Dalai Lama
did not suggest either abdicating science for religion, on
one hand, or abdicating religion for science, on the other;
rather, he expressed his respect for science alongside,
religion, and he offered his hope that our age would find a
union between scientific and religious perspectives in the
search for knowledge of the healing traditions.”101
Biomedicine and systems of healing like Tibetan medicine can operate

Religion. North Carolina: UNC Press, 2006: 4
Devin Gonier 80
both integratively and parallel to each other. The danger of integration,
as was noted earlier, is that it can easily slip into “erasure.” The
difficulty is maintaining the autonomy of Tibetan medicine when it
must exist in cooperation with another system that is antithetical to
some of its philosophical presuppositions. But, if both can acknowledge
an epistemological autonomy for the other, by acknowledging that
each has a certain coherent model for understanding the body, then
both can potentially prosper side by side. In order for this to happen,
biomedical doctors may attempt to take an interest in healing systems
like Tibetan medicine, so that they may know what works well in
Tibetan medicine. In order for this to happen, doctors must learn the
language of Tibetan medicine, and learn about it on its own terms.
Making connections between Tibetan medicine and biomedicine is
important, but they both utilize different epistemologies, and those
epistemologies must be protected from erasure. But, simultaneously
these doctors must also begin to acknowledge alternatives to the
biomedical model, so that they can fill in those gaps by recommending
other models of healing. The same must be true for a healing system
like Tibetan medicine if it is to be successful in the west. It is quite
common for a Tibetan medicine doctor to recommend a biomedical
doctor in certain cases. The future paradigm of healthcare can be in
cooperation and understanding of separate coherent models of
thinking of the body. One day, a hospital might have Ayurvedic

Devin Gonier 81
medicine, Tibetan medicine, Reiki healing, and biomedicine.102 Each
hospital might be unique in its own coherent internal systems. Each
physician if they can maintain an open mind, will be able to provide a
greater opportunity for healing by understanding the success and
failings of the other systems. This may manifest in the form of
caregivers being “fluent in multiple Western and Eastern modalities,
from biomedicine to traditional oriental medicine, and to be able to
shift effortlessly between the two in the best interest in the patient” or
“In institutional terms, such integration or synthesis might mean the
ability to provide a care team conversant in multiple clinical disciplines
and languages that can interactively assess, respond, and refine,
initially diagnosing and subsequently measuring the patients progress
through multiple channels.”103 Furthermore, such a system will
accommodate the growing desire for patients to choose what kind of
healthcare they desire. Rather than these systems competing, or one
system erasing another, these systems could be cooperating and
growing together. Healing has a bright future if this can be achieved; a
future where doctors work side by side doctors from entirely different
traditions, and knowledge of the body is organized into coherent
models, but even more significantly where the patient can choose how
102 Such Clinics already exist in Nepal and China, like the She Chem
clinic located in Kathmandu, Nepal, which has an allopathic physician,
Ayurvedic physician, and Tibetan medicine Amchi on staff in one place
all the time.
Religion. North Carolina: UNC Press, 2006: 11
Devin Gonier 82
they should treat their illness, and in what way they should understand
their body.
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Lama Lodru Lama of Sakya Early Darjeelin
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2008 Bengal
Karma Gyurme Geshe of White Late Kathman
Temple April du, Nepal
2008
Padme Yudron Tibetan Teacher – Mid Dharams
for the perspective May ala
of a Tibetan person 2008
in Dharmsala
Devin Gonier 87
Name Position Time Place

Dr Dhondup Amchi of Tibetan Early Darjeelin
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Dr Kunchok Amchi of Tibetan Late Leh,
Tsering medicine Clinic April Ladakh
2008
Amchi Ngawang Head Amchi of the Mid Kathman
Thinley She Chen Clinic May du, Nepal
2008
Dr. Gyalmo Amchi of Tibetan Late Mccleoud
Khangkar medicine clinic May Ganj
2008
Dr. Tamdin President of the June Dharams
Men Tsee Khang 2008 ala
College
Dr. Dolma Head of the R&D June Dharams
Dept. of Men Tsee 2008 ala
Khang HQ
Dr. Tenzin Clinical Researcher June Dharams
Namdul at the R&D Dept of 2008 ala
Men Tsee Khang HQ
Prof. Dr. Tsering The Translation June Dharams
Drungtso Dept. of the Gyushi 2008 ala
and accomplished
writer for the Men
Tsee Khang
Dr. Tsering Dorje Member of the R&D June Dharams
Dept. of Men Tsee 2008 ala
Khang
Dr. Phil Weber Amchi at a Holistic July Boulder,
Medicine clinic 2008 CO

Tibetan Medicine as a Western Narrative of Healing

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Tibetan Medicine as a Western Narrative of Healing

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1

Combining stories: Reading Tibetan Medicine as a Western

This project was funded by the Carnegie Mellon Grant

It would be very useful for humanity if Tibetan and Western medicine

Healing as we know and understand it today has both a historical

it in the future. There will be technological advancements that improve

1 David B Morris, Illness and Culture in the Postmodern Age. California:

discourse on health and the philosophical assumptions inherent within

view that disease is something objective and that it can be cured

through objective processes. But, one must tread carefully in this

thinking, since different cultural and historical contexts change how a

by looking closely at the diversity of medicines throughout the world.

Different socio-cultural situations influenced or not by religion have

directed medicine and health in unique ways. Different types of

medicine have a long history of intersection and these intersections

continue to grow today. The focus of this paper will be specifically on

the intersection of biomedicine and Tibetan medicine, and it will argue

that current U.S. healthcare discourse creates barriers for religious

healing systems like Tibetan medicine. Unless cultural and institutional

changes are made, it will continue to be difficult for Tibetan medicine

and other healing systems similar to it to have a legally and culturally

accepted role in U.S. healing.

Thesis and Structure

discourse and treatment process are predominately influenced by

scientific materialism and the hegemonic status of biomedicine in

healing. The U.S. healthcare discourse creates great difficulties for

alternative, complementary, and integrative models of healing, which

cannot be entirely reduced to a biomedical scientific model, to become

the views of postmodern medicine, because of its basic advocacy for

empowering marginalized voices in the pursuit of a more

heterogeneous healthcare system. The focus will be on the particular

relationship between Tibetan medicine and biomedicine in the U.S.,

and how this relationship can be improved based on the principles of

postmodern medicine. There are two supporting arguments. First,

postmodern medicine reconceptualizes the relationship between

religion and healing by disrupting the hegemonic biopolitical status of

secular healing in the U.S. In other words, postmodern medicine

creates space for religious healing in a system dominated by secular

healing. Second, the principles of postmodern medicine suggest a

heterogeneous globalization model, which resists what medical

anthropologist Vincanne Adams’4 calls erasure.

4 Vincanne Adams is a noted scholar of Tibetan medicine. She is a

The first section of this paper outlines some crucial concepts

about Tibetan medicine and also explains the status of complementary

the tenets of reconstructive postmodern medicine, and examines how

Tibetan medicine fits within the paradigm of postmodern medicine. The

third section outlines the deconstructive elements of postmodern

medicine, which critique biomedicine’s hegemonic status within the

U.S. After this description of postmodern medicine and its relationship

to biomedicine and Tibetan medicine, the paper will analyze how

religion and medicine intersect in the U.S. mainstream health care

healing is hegemonic. Finally, it examines the concept of globalization,

and utilizing much of Vincanne Adams’ work, analyzes the biopolitical

role of the NCCAM6 and suggests a more heterogeneous model for

sake of incorporating the other.”

thinking about healing in the U.S. as a result of the application of

postmodernism. Based on some of the principles of postmodern

medicine, the paper concludes by suggesting that our healthcare

system should be more open to other forms of healing which cannot be

easily integrated into the biomedical secular model of thinking. Before

getting into background information about the U.S and alternative

medicine, Tibetan medicine will be summarized and its most basic