Relevance of the Bhagavad Gita for modern psychotherapy: Gita---A Panacea for COVID 19
[Compilation for a discourse by N.R. Srinivasan, Resourced from Newspapers and Journal Releases and Google Sources, Suitably Edited, to make available at one February 2021]
Pathak a professor of management, writer, and an acclaimed public speaker writes:
“With no end in sight, the Corona pandemic continues to take its toll on human health. More in terms of mental than physical. Even as the International Labor Organization study finds that one out of two young people are subject to anxiety and depression, there are scant efforts to handle this psychedelic. The young apart, the old as well as the children, are also suffering from the mental distress. The Covid-19 protocol further adds to stress and fear. The very feeling that wearing mask gives is sickening. People are scared to venture out and are confined to homes unless it is necessary.
As we appear clueless about the answer to the pandemic, let us try to find the solution in the Bhagavad Gita. The lessons may, perhaps, show us the way to cope with Corona fear and anxiety. Many of us, like Arjuna, are burdened with anxiety and fear of the impending war and seem to have given up. It is this giving up that is the most dangerous of all the psychological states that leads to most of the problems of mental health. Arjuna, out of fear of adverse outcome, tells the Lord that he sees little point in fighting the war which he is not sure to win. Rather, in the heart of his hearts, he thinks he is going to lose. It is then that Lord Krishna recites his essential Gita lessons, suggesting why fighting is important, winning or losing being of little consequence. So Krishna tells Arjuna to drive away his fear and ready himself for the war.
We are in a similar plight in this COVID situation and our fear is of defeat or death and anxiety of uncertainty of the outcome. Gita lessons offer the panacea for living in turbulent times which in Management jargon is a VUCA world, that is Volatile, Uncertain, Complex and Ambiguous. The principal lessons of Gita can be summed up in the following basic tenets.
First and foremost is to drive away your fears and submit to God with full faith. The second is to prepare yourself to fight and for this you need to learn to control your mind, which is the biggest distraction. The third tenet is to focus on effort and not to worry about the results. Worrying about the results will sap vital energy you need to apply, in order to put wholehearted efforts. The results are not in your hands as some other force controls the outcome. You only have right to efforts. But the Lord also says that if efforts are put in wholeheartedly and with full faith in God results will be achieved. As the battle with Corona is still on, fear is the biggest detriment in influencing the efficacy of our response. Have faith in God and fight that can affect experiences and the balance off the resilience scale” --writes the professor in the Daily Pioneer.
The worldwide outbreak of the coronavirus disease (COVID-19) is a source of unexpected stress and adversity for many people. Resilience is not something we’re born with—it’s built over time as the experiences we have interact with our unique, individual genetic make-up. That’s why we all respond to stress and adversity—like that from the COVID-19 pandemic—differently. How can we build resilience to plan ahead for future times of crisis? The science of child development points to three ways:
We can lighten the load on the negative side of the resilience scale by reducing sources of stress for families and program staff. Many organizations are already doing this and can draw on their experience to prepare for possible future periods of physical distancing and shutdown.
We can add to the positive side of the resilience scale by piling on positive experiences—especially through responsive relationships. The one thing that most children who develop resilience have in common is a stable, committed relationship with a supportive parent, caregiver, or other adult. Adults need those supportive relationships, too!
We can make it easier for a scale to tip toward positive outcomes by strengthening core life skills. All of us need executive function and self-regulation skills to manage daily life, but stress makes it more difficult to use the skills we have. During the COVID-19 pandemic, we need these core life skills for planning things for our daily needs.
During a crisis like the COVID-19 outbreak, families need their immediate, basic needs met before they can focus on anything else. But, when the crisis is over, longer-term programs that support adults and children in building and practicing their core life skills will again be necessary and effective.
In this context please go through an educative and valuable article published in the Indian Journal of Psychiatry, last year.
The Bhagavad Gita is more relevant than ever, especially now in the midst of the Covid-19 pandemic, says an article in The European Heart Journal, a peer-reviewed journal of cardiology published by Oxford University, and likened “Prince Arjuna” to healthcare workers and the Kurukshetra battlefield to hospitals.
Published on 5 June 2020 Psychiatric Journal in Delhi, in an article drew parallels between Arjuna’s predicament and the Covid-19 pandemic which has put healthcare workers at odds with their profession. While, in the Gita, the context was Arjuna’s duty to uphold dharma (the philosophy of right thought and action governing the order of things), in today’s reality, it’s dealing with a disease that has infected more than 64 lakhs people and killed almost 4 lakhs. The article said healthcare workers are carrying out their dharma selflessly amidst the chaos, and added they shouldn’t become “paralyze by the outcome”, like Arjuna was before the battle.
In the midst of a pandemic, the Bhagavad Gita is more relevant than ever — the healthcare worker is Arjuna, hospitals are battlegrounds for the war against the virus and misinformation, the lack of a cure or an effective containment strategy, and a system that has failed us,” said the article titled ‘Lessons from the Bhagavad Gita (the ‘Lord’s Song’), from India during these difficult times’.
Explaining the gist of the text, the three authors — Ankur Kalra, Erin D. Michos, and Kavitha M. Chinnaiyan — said, “It was a war unlike any other.” Covid-19, the article said, “has challenged clinicians’ professional commitment to their communities and to humanity, accompanied by a sacrifice of their own safety and of the safety and needs of their families”. The Bhagavad Gita, it added, also teaches that we must learn to detach ourselves from the results of our actions and denunciate the desire for a particular outcome.
“Clinicians cannot have complete control over a clinical situation, but they can rise to perform their clinical duties and service with equanimity. Although we must continue to act in the best interest of our patients, practice evidence-- (and not fear-) based medicine, and not ‘leave any stone unturned’ in instituting timely interventions to help save lives, we must also embrace the vulnerability of life, and respect the fact that neither life nor death are in our control,” the authors said.
The Doctor’s Dilemma during COVID-19 Pandemic: Solutions from Bhagavad Gita.
Dr Nitin P Ghonge @ a breath of fresh air
“The Bhagavad-Gita is the eternal message of spiritual wisdom from ancient India which can answer questions about our lives and existence.
The pandemonium of COVID-19 pandemic has presented unprecedented set of dilemmas for the doctors across the globe, as emphasized in my previous blog. The inner conflicts in doctor’s mind may adversely impact the chances of winning this unique war against the unseen enemy. What is the solution?
Bhagavad Gita can address the mind’s inner conflicts while treading the noble path to service and guide Doctor’s action during the pandemonium of COVID-19 pandemic.
Mahatma Gandhi referred to Bhagavad Gita as a ‘spiritual dictionary’ for better decision-making at the cross-roads of life. Bhagavad Gita can certainly address the inner conflicts in Doctor’s mind and may offer help to resolve their ethical dilemmas during the COVID-19 pandemic. These teachings may bring courage and clarity in the minds of healthcare professionals as the long-drawn war against COVID-19 would require utmost patience and perseverance.
Equanimity of mind: This is the ability to keep the mind steady and balanced in ups and downs of life with serene and peaceful outlook to vicissitudes of life. Doctors need to remain calm and cheerful, amidst the doom and gloom of COVID-19 pandemic.
“Equanimity of mind is Yoga. Do everything centered in that equanimity and you will enjoy an undisturbed mind in success or failure” says Gita.
Equanimity and evenness of mind are the greatest assets for Doctors during the present crisis and can be cultivated with regular meditation and radical change in the attitude. Doctors need to make continuous efforts to train their mind and develop ‘non-attachment’ with the human sufferings. This certainly does not mean lack of empathy and compassion, which are essential traits of physician. The ‘non-attachment’ approach to crisis will allow a clear ‘bird’s-eye view’ of the situation and will help the doctors to perform in more efficient manner.
“The mind is restless and difficult to restrain, but it is subdued by practice”. “The mind alone is one’s friend as well as one’s enemy” says Gita.
Bhagavad Gita has described such a person with focused mind and steady wisdom as ‘Sthitaprajnya’. If the doctor’s mind remains unperturbed with uncertainties of the present times and is free from attachment, anxiety and fear, he or she can perform much better. Equanimity of mind will allow doctors to perform at their best in terms of clinical acumen, technical skills and scientific knowledge for the patient’s well-being.
Perform without worrying about the results: The Bhagavad Gita emphasized on the need to perform actions without worrying about the results or rewards or recognition. It is important to realize that the outcome of human’s action is not only dependent on the work but also on lot of related factors and circumstances.
“The power of God is with you at all times; through the activities of mind, senses, breathing, and emotions; and is constantly doing all the work using you as a mere instrument”--says Gita.
Even in routine clinical practice, the same set of treatment protocols may have variable responses in two different patients and the same will happen during this pandemic, when treatment protocols are not standardized across the globe. Doctors cannot expect complete control over the clinical outcomes, but they can have control over their own actions which should be performed in the best possible manner. Doctor’s decisions will become much more difficult if they attach themselves with the outcome of the treatment. Doctors are expected to perform their obligatory duties in the best interest of patients, without worrying about the outcomes and circumstances.
Treat everyone equally: It is natural for humans to become judgmental of situations and persons around us. The Bhagavad Gita, however, mentioned that the doctors should treat all patients with the same lens of impartiality.
“I look upon all creatures equally; none are less dear to me and none more dear”-says Gita.
With the available resources at the COVID-19 frontline, Doctors need to provide the best treatment to every patient. It is appropriate for doctors to communicate about the scarcity of personal protection equipment, but that should not discourage them from performing their duties. Doctors looking after the non-COVID patients should follow the same approach.
The panic response of the society related to the COVID-19 may prove to be a bigger problem than the medical problem alone. Doctor can also play a crucial role in providing correct patient education. The tendency to stockpile the sanitizers at home, when they are more essential at the hospitals is just one example. Sir William Osler has correctly mentioned that the “best disinfectants are Soap, Water and Common sense”.
Handling the Stress: In modern society, ‘workplace stress’ has almost become a norm and symbolic of stature in the society. Factually, the stress is the outcome of inability to efficiently handle the assigned roles and responsibilities. Everyone has to fight their own battles to lead a productive and purposeful life and should be ready for tough times. ‘When the going gets tough, only the tough gets going’; simply reminds us of the nature’s basic law of ‘survival of the fittest.
“The one by whom others are not agitated and who is not agitated by others, who is free from joy, envy, fear, and anxiety, is also dear to Me” says Gita.
Doctors should understand that they have chosen this noble profession because of their passion for Medicine and commitment to serve. The COVID-19 crisis is a once in a lifetime crisis and will be the testing time for doctors in terms of their professional commitment and sincerity to work.
“They all attain perfection, when they find joy in their work”--says Gita.
Always remember, “The things you are passionate about are not random, they are your calling” says Gita. Doctors need to respond to their calling, rise to occasion and serve the humanity in these challenging times.
Act with conviction: It is important to realize that having faith is not inferior to cultivating knowledge. Having faith is not opposed to being reasonable or scientific. Faith thrives in an environment of enthusiasm backed with evidence.
“Whatever is done without faith – whether it is sacrifice, charity, austerity, or any other act is useless. It has no value here or hereafter, O Arjuna.” says Gita.
Though, treatment protocols for COVID-19 are presently struggling between ‘evidence-based approaches’ and ‘limited experiences’ with use of Hydroxychloroquine in viral infections. It is prudent to use Hydroxychloroquine after due safety precautions rather than waiting for clinical trials. Doctors always need to perform their duties with confidence.
Act without fears: Doctors are vulnerable to infections which can instill fear, mainly if personal protection equipment are not available. The fears stem out of care and concern for their family and for their patients.
“Fear not what is not real, never was and never will be. What is real, always was and cannot be destroyed” says Gita.
Based on clinical acumen, available scientific evidence and patient’s need, Doctors need to perform without any fear in present times. They should follow government guidelines regarding the pandemic and lockdowns as applicable to hospitals and clinics. Unless, there are specific compelling reasons, doctors should continue to provide their services without any fear of catching the sinfection or harassment.
Set high standards: Even today, Medicine is the most respected profession. The Doctors need to set high standards for the society in terms of professional commitment, moral obligations, ethics, work discipline and good personal health.
“Sever the ignorant doubt in your heart with the sword of self-knowledge. Observe your discipline. Arise” says Gita.
“Physician heal thyself” is a common phrase from biblical times, which believed that physicians could better cure the disease, if they heal themselves. Basic sanitation and cleanliness should be promoted by doctors, as their social responsibility. Love and respect for nature is an important lesson for the humanity, where doctors can lead. Truly, “It is always better to light a candle than to curse the darkness”.
Change is inevitable: As in life, the only thing constant in Medicine is Change. We should accept change as a central rule of our existence on this planet. The tough times will soon pass. It is certainly important to learn from them and embrace the change for the greater good.
“When inertia is predominant; ignorance, inactivity, carelessness, and delusion arise” says Gita.
In recent times, as the practice of medicine gradually became the industry of healthcare, there are increasing incidences of violence against the doctors and decline in the trust. Lack of personalized approach, sub-optimal counseling, or communication high healthcare costs and un-realistic expectations from medical sciences are few key reasons. The present crisis is the golden opportunity for the doctors to reform the healthcare, rebuild this trust and regain the same old respect as the ‘Healer’.
“For the protection of the good, for the destruction of the evil and for the establishment of dharma (righteousness), I (the Lord) am born from age to age” says Gita.
The doctors should now drive this ‘change’ for building a better healthcare for tomorrow. Future healthcare should establish greater synchronization with Nature and adopt ‘evidence-based lifestyle medicine’ [ELSM]. Mind-body connection should be accepted as a key concept in healing. The healthcare should move from ‘Volume-based’ to “Value-based’ model in the interest of society. As Mahatma Gandhi has said, “Be the change, you want to see in the World”.
Summarizing the solutions: In this mystical circle of life, the material world often discard the wisdom of one generation as absurdities in the next generation and even vice versa. The timeless teachings of Bhagavad Gita however, transcend all the barriers of time and religion. The highly revered Bhagavad Gita is a divine philosophy of eternal wisdom addressed to humankind of all times and shows light in darkest of times.
The above teachings of the Bhagavad Gita can enlighten the doctors to efficiently handle their dilemmas and continue their selfless service to society during the COVID-19 crisis. They should develop equanimity and evenness of mind and treat everyone equally. Doctors should perform with absolute focus and confidence without worrying for results and without any fears. This is the time to set high standards for the society in terms of professional commitment, moral obligations, work discipline, compliance with guidelines and good personal health. Doctors also need to drive the inevitable change for building a better healthcare for tomorrow, as the dust settles over the COVID-19 crisis.
With huge hopes that the COVID-19 pandemic soon goes down the history as triumph of human’s indomitable spirit and determination, who are indeed God’s finest creation. With high hopes that Doctors respond to their calling, resolve their dilemmas with timeless teachings of the Bhagavad Gita and rise to the occasion, during this once in a lifetime crisis. “
The author concludes the article with the advice “Inhale FAITH and exhale FEAR”.
Building resilience in the COVID-19 era: Three Paths in the Bhagavad Gita
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
The COVID-19 pandemic has emerged as a major stressor of a global scale, affecting all aspects of our lives, and is likely to contribute to a surge of mental ill health. Ancient Hindu scriptures, notably the Bhagavad Gita, have a wealth of insights that can help approaches to build psychological resilience for individuals at risk, those affected, as well as for caregivers. [To me, GITA stands for Govinda Intuitively Tells All.] The Path of Knowledge (Jnana yoga) promotes accurate awareness of nature of the self, and can help reframe our thinking from an “I” to a “we mode,” much needed for collectively mitigating the spread of the Coronavirus. The Path of Action (Karma yoga) teaches the art of selfless action, providing caregivers and frontline health-care providers a framework to continue efforts in the face of uncertain consequences. Finally, the Path of Meditation (Raja yoga) offers a multipronged approach to healthy lifestyle and mindful meditation, which may improve resilience to the illness and its severe consequences. [So, we find urban monks like Swami Chidananda of FOWAI forum are engaged in a series of weekend discourses on these three paths and so also the philosopher Jaya Row of Vedanta Vision. While more work is needed to empirically examine the potential value of each of these approaches in modern psychotherapy, the principles herein may already help individuals facing and providing care for the COVID-19 pandemic. In this context, please go through an excellent presentation of another busy doctor, Dr. Anand Kulakarni, who is currently busy with providing healthcare service to COVID 19 patients in UK, who at the same time is spiritually buszy too, and has a presented a paper for our benefit: “Gita-A Panacea for COVID 19”.
I am amazed and at the same time soul-searching as to the his motivation to dedication to Diagnostic Therapy, Family, EQ and SQ Management of Dr. Anand Kulakarni of UK who joins the team fighting the global war and alleviating human sufferings. He is at the same time motivated by the Gita Message: Veetaraga-bhaya-krodhah sokha-lobha-bheetih yudhyasva Coronavishajwaram vigatajvarah--Devoid of passion, fear, frustration, grief, greed and panic fight the Corona Pandemic without anxiety! ]
The COVID-19 crisis has changed our world in just a matter of months, thrusting us into danger, uncertainty, fear, and of course social isolation. At the time of this writing, over 11 million individuals have been affected worldwide (India is fourth among all countries, 674,515) and over half a million people have died. The COVID-19 pandemic has been an unprecedented global stressor, not only because of the disease burden and mortality but also because of economic upheaval; the very fabric of the society is disrupted, affecting housing, personal relationships, travel, and all aspects of lifestyle. The overwhelmed health-care system is among the most major stressors, leading to a heightened sense of vulnerability. No definitive treatments or vaccine is on the horizon yet. Psychiatry has to brace up to an expected mental health crisis resulting from this global stressor, not only with regard to treating neuropsychiatric consequences but also with regard to developing preventive approaches and building resilience.
Thankfully, there is a wealth of wisdom to help us in our ancient scriptures such as the Bhagavad Gita for building psychological resilience. The Bhagavad Gita is a dialog between the Pandava prince Arjuna and his charioteer Krishna in the epic Mahabharata, the great tale of the Bharata Dynasty, authored by Sage Vyasa (c. 4–5 B.C.E.). The dialog occurs in the 6th chapter of the epic and has over 700 verses. In this epic story, Arjuna, the righteous Pandava hero was faced with the dilemma of waging a war against his cousins, the Kauravas, for territory. Arjuna is confused and has no will to initiate the war. In this context, Krishna, his charioteer and spiritual mentor, counsels him. The key principles of this spiritual discourse in the Gita are embodied in the broad concept of yoga, which literally means “Yog” or “to unite.” Applying three tenets of yoga can greatly help developing resilience at individual, group, and societal levels. A fourth path, Bhakti yoga, is a spiritual approach in the Gita which emphasizes loving devotion toward a higher power or principle, which may or may not involve a personal god. In this editorial, I focus on three paths that have considerable relevance to modern approaches to reliance-focused psychotherapy that may be especially relevant in the COVID-19 era.
Path of Knowledge
The first concept in the Gita is the path of knowledge (Jnana Yoga, chapter 2). The fundamental goal of Jnana yoga is to liberate oneself from the limited view of the individual ego, and to develop the awareness of one's self as part of a larger, universal self. Hindu philosophers were among the earliest to ask the question of “who am I” and concluded that the self is not what it seems. The self as we all know is a collection of our physical, mental, and social attributes that we create for ourselves with input from our perceptions, and input by our families and society. Such a world view leads to a tendency to crave for the “I” and for what is mine, and not consider the “We.” As Krishna in the Bhagavad Gita points out, the person who sees oneself in others, and others in oneself, really “sees.” Such awareness, which guides action in service of self as well as others, is critically important in our goals of collectively preventing the spread of the coronavirus. A glaring example is the use of face masks, known to effectively slow the viral infection. Using the mask is as important to protecting oneself from the virus as well as protecting others from oneself. Nations such as the USA (and their leaders), who have given mixed messages to the public about the need to wear masks, have been showing a strikingly high number of cases as well as mortality. Unfortunately, such reluctance to wear masks (and thus model protective hygiene for the population), as in the case of the US leader, has stemmed from ego or vanity-related issues (i.e., how he would appear to other leaders!). This factor may at least partly underlie the worse COVID-19 outcome in the USA; the simple lesson here is that it is important to first flatten the ego if one wants to flatten the pandemic curve!
Path of Action
The second key concept is the path of action (Karma yoga, chapter 3). Karma yoga is all about taking action without thinking, “what's in it for me.” As such, it seeks to mainly let go of one's ego. In the Bhagavad Gita, Arjuna is ambivalent about fighting because of the conflict regarding the outcome brought on by waging the war, i.e., having to kill some of his own kith and kin. Krishna reminds him that he should not hesitate, because it is his nature and duty (or Dharma), as a warrior, to protect the larger good, though it will have some downside consequences. The frontline health-care worker caring for severely ill patients with COVID-19 is likely to have a similar emotional reaction as Arjuna, facing a lack of adequate treatments, high likelihood of mortality and of unpredictable negative outcomes, and risk to him/herself. Compounding this, especially when resources such as ventilators are limited, the doctor may have to make tough decisions of whose life to save and whose not. Adding to this are personal emotions when facing with the death of patients, having to deliver bad news, and dealing with grieving relatives. All these are likely to result in emotional anguish and guilt, leading to burnout and a war “neurosis.”
So, what should the frontline
health-care provider should do? Krishna's counsel would be that the doctor
should continue to perform his/her own dharma, but do so without desire or
attachment, thereby performing action in the spirit of Karma yoga. Such action
would be with detachment, without a desire for personal gain and being
unperturbed by success or failure. Such “Nishkaama
Karma” (or selfless action) may help doctors working today in the COVID
outbreak to carry forward their work with compassion, and accept the results of
their actions with equanimity and without guilt. Krishna points out that
training one's mind to engage in selfless action is not easy but requires
practice (Abhyasa). Krishna is also
emphatic about the need to protect oneself, in order to be able to effectively
carry out one's duties.
Path of Meditation
The third core concept in the Gita is the path of meditation and self-reflection (Raja yoga, or Dhyana yoga, chapter 6). It is considered the royal path (Raja means royal) for attaining self-realization, and often considered the 8-fold path of yoga (Ashtanga yoga) designed to discipline lifestyle, the body and mind toward realizing mindfulness and self-reflection. These techniques, which originated in India over two millennia ago, have evolved over recent decades and anticipate several approaches to contemplative psychotherapy, including dialectical behavior therapy, acceptance and commitment therapy, and mindfulness-based stress reduction, These approaches are of particular relevance for stress reduction and resilience building in individuals faced by COVID-19-related emotional difficulties as well as health-care providers.
The majority of people affected by the COVID-19 virus recover, but about 20% have severe disease, and the mortality is around 5%. Older individuals, those with obesity and comorbid medical illnesses such as diabetes and lung disease, are particularly prone to developing severe disease. It is possible that a state of chronic low-grade inflammation which underlies each of these conditions may increase the risk of disproportionate host immune reactions (with excessive release of cytokines), characterizing severe disease in those with COVID-19. With this in mind, it is important to note that exercise, some forms of meditation, anti-inflammatory and antioxidant diet (such as turmeric and melatonin), and yoga have known benefits in reducing inflammation. Sleep loss also elevates inflammatory cytokines; healthy sleep may reduce inflammation. Clearly, a healthy lifestyle, including healthy sleep, exercise, and diet, may be protective against developing COVID-19-related severe complications. These principles of healthy living are beautifully summarized in the Bhagavad Gita.
Yuktahara-viharasya yukta-cestasya karmasuYukta-svapnavabodhasya yogo bhavati duhkha-ha || (Bhagavad Gita, Chapter 6, verse 17)
He who is temperate in his habits of eating, sleeping, working and recreation can mitigate all sorrows by practicing the yoga system.’’ concludes the author.
Note: My observations are within [ ….. ]
Bhagavad Gita – A Panacea for COVID 19
Dr. Anand Kulkarni
[This is an unprecedented global war and the mankind is facing the same enemy. The battlefield is the hospital and our soldiers are the medical workers.]
As the world continues to deal with the outbreak of coronavirus, there is increasing anxiety, dilemmas, nervousness, faint-heartedness amongst the doctors, nurses and health care workers. Dealing with coronavirus is the biggest challenge to face the health sector as it’s going to ask a lot of them all. I am a doctor myself and none of us have experience of a pandemic like this.
The outbreak was declared a Public Health Emergency of International Concern on 30 January 2020. The World Health Organization declared the outbreak of COVID-19 a pandemic on the 11 March 2020, this means COVID-19 has already spread worldwide.
For those on the health sector frontline, the call is to step in, while the rest of society steps back. The situation demands it. This is an unprecedented global war and the mankind is facing the same enemy. The battlefield is the hospital and our soldiers are the medical workers. Doctors and nurses are leading the fight in a ‘war’ with an ‘enemy’ we don’t yet fully understand. As they race to respond, they will face being ill themselves, may succumb to virus and die, may spread the virus to loved ones and public. The pressure will be immense and hence the emotional outpouring and mental weakness of doctors and nurses. Should they treat these patients or refuse for above reasons and stay at home? What if they die in the process? If they can’t cure the disease the disease might kill doctors and nurses! This reminds me of Arjuna’s Vishada yoga and the preaching of Lord Krishna in Bhagavad Gita.
kutastvā kaśhmalamidaṁ viṣhame
samupasthitam
anārya-juṣhṭamaswargyam akīrti-karam arjuna
klaibyam
maa sma gamah paartha naitattvayyupapadyate |
kshudram hridayadaurbalyam
tyaktvotishtha parantapa || 3 ||
[The Lord
said: Whence could such faintheartedness have come upon you at this time of
trial? This is not proper for a civilized man, it does not lead to heaven and
it will bring dishonor upon you. Do not give up your manhood in this way,
Partha! Such a mood ill becomes you. Giving up this pathetic weakness of heart,
arise, O destroyer of the foe]
Like Arjuna, doctors working in this pandemic, have some viable arguments and anxieties. Lord Krishna seems to regard the whole thing as a form mental weakness. Hence Lord Krishna’s first reply is also on the emotional level. He does not seek to answer any of Arjuna’s arguments but turns immediately to the emotional trauma that is at the heart of them. In other words, Lord Krishna is saying that Arjuna’s speech is not worthy of a reasoned response because it is the product of emotional turmoil rather than logical analysis. I think the same applies to doctors as of today. Doctors are in need of psychotherapy and I sincerely think Bhagavad Gita offers them exactly the same! Despite this, it is a shame that some of the doctors and nurses are hiding in their comfortable homes avoiding their ‘duty” whilst most (90%) of the other doctors continue to face challenges. I do not blame them as they are in a state of ‘Vishaada’ (grief) and need some inspiration.
Arjuna as a ‘soldier’ was worried that waging war would amount to killing of many of his own family members. In this global COVID war, the family members are worried about distancing or losing their loved ones. They are overwhelmed with deep sense of compassion for a variety of reasons. The fundamental response to the situation has been highly emotional one and never ever seen before. The kids can’t come running to hug their parents as soon as they come back home! One doctor in my department has isolated from his full term pregnant wife so that he can look after patients and don’t pass on virus to his wife! Some doctors and nurses have been put up in hotel so that the vulnerable members of their family can be protected and yet they continue to work! Every morning when I leave for the hospital, my wife and kids come to door to see me off and there is a minute of dead silence and I have a ‘lump’ in my throat! Unspoken anxieties? Worries? This is a never ending emotional trauma.
Yet, the health care workers have to put these emotions behind them when they reach the hospital and carry on caring for patients as if nothing has happened. On the advice of Lord Krishna, Arjuna had to put his emotions behind and fight the war for establishing Dharma. The doctors and nurses have a job of ‘saving lives’. In this pandemic situation and when the hospital wards are crowded with hundreds of patients, we have to make tough decisions of whose life is to be saved and whose not? The death rate is 50% in intensive care admissions. How do we emotionally cope when we have to say the treatment has been futile and it is time to withdraw care? How emotional it is when the patients are dying and the family members cannot visit them or have to say ‘bye’ over the video! Fortunately we have local escalation plans from regulators, if/when patient numbers increase beyond current capacity and this helps to ensure that our system is resilient enough to not only manage the crisis but sustain it.
It is also important at this stage we
consider medical staff wellbeing and resilience and this is where Bhagavad Gita
plays a big role. The religious leaders should provide this as a medicine to
health care workers at this crucial time.
There’s a reason our health service is held in such high regard. It’s the staff.
It’s the skill, selflessness and resilience that doctors and nurses demonstrate
to every patient, every day. The values and behaviors required of our
clinicians are well established. The tenets of being a good doctor have not
changed. The nature of being a doctor is to go above and beyond to deliver the
care our patients require.
Speaking of performing one’s duty Lord Krishna says it is ‘personal dharma’. For a Kshatriya, there is nothing superior to fighting for the sake of dharma. For a doctor, there is nothing superior than delivering the care our patients require. This of course applies to doctors in the present situation. Doctors are trained to perform a set of actions i.e. care for the patients. Therefore, doctors abandoning this battle and renouncing their duty is perverse and wholly impractical.
I can quote 31-38 verses of chapter 2 of Bhagavad Gita but it is suffice if I quote these two:
Atha chettwam imam dharmyam
samgraamam na karishyasi|
Tatah swadharmam keertim cha hitwaa paapam avaapsyasi || 2-33||
akīrtiṁ
chāpi bhūtānikathayiṣhyanti te ’vyayām |
sambhāvitasya chākīrtir maraṇād atirichyate || 2-34 ||
[1. And if you do not engage in this dharmic battle then both your personal dharma and your honor will be destroyed and you will accumulate sin. 2. People will then speak of your everlasting dishonor and for a person who has achieved renowned, dishonor is worse than death.]
Doctors should continue to perform their own dharma, but do so without desire or attachment, thereby transforming karma into karma-yoga. The practice of karma-yoga consists of the performance of proper action in a mood of unmoved by the success or failure of the action undertaken. Acharya Madhwa interprets this with a new term called ‘Nishkaama Karma’. This is so much applicable to the doctors working today in COVID outbreak.
It is a shame that some doctors are demanding exorbitant amounts of remuneration for performing their duties in the current situation and trying to make a quick buck. The same is true with some drug companies claiming their medications to be effective, while they are not.
This is to be condemned. This reminds me of the famous verse from Bhagavad Gita:
karmaṇy-evādhikāras
te mā phaleṣhu kadāchana
mā karma-phala-hetur bhūr mā te saṅgo ’stvakarmaṇi ||
2-47 ||
yoga-sthaḥ
kuru karmāṇi saṅgaṁ tyaktvā dhanañjaya
siddhy-asiddhyoḥ samo bhūtvā samatvaṁ
yoga uchyate || 2-48 ||
[1. You have a right to perform prescribed action but you are not entitled to the fruits of that action. Do not make the rewards of action your motive and do not develop any attachment for avoiding action.
2. Situated in yoga, perform your actions giving up all attachments, Dhananjaya. Remain equal in success and failure for such equanimity is what is meant by yoga.]
The GMC (General Medical Council) UK has made it very clear about this fact in their handbook on ‘good medical practice’.
Responding to this pandemic will require doctors to do things differently. It will require them to be flexible and work right to the edge of their comfort zone, and in some cases beyond. Doctors may be asked to work in unfamiliar circumstances or surroundings, or in clinical areas outside of their area of usual practice. This is very much acceptable as stated in Bhagavad Gita:
śhreyān
swa-dharmo viguṇaḥ para-dharmāt sv-anuṣhṭhitāt
|
swa-dharme nidhanaṁ śhreyaḥ para-dharmo bhayāvahaḥ || 3-35 ||
[Even though it may have faults, one’s own dharma is still superior to accepting the dharma of another, even if it is perfectly observed. Death in the pursuit of one’s own dharma is better, for another’s dharma is a source of danger.]
Even though it may have faults, being a doctor and caring for patients in other specialties is still superior to accepting the duty of other professions, even if it is perfectly observed. So, it is perfectly all right to care for patients in other areas of medical specialty and still be a caring doctor!
If the war fought by Arjuna was at Kurukshetra, this war is COVID world war. If the enemy there was Kaurava, the enemy here is COVID 19. We know how dangerous and strong our enemy is, but, we don’t know how to destroy this enemy. What astraas? What weapons?
How many people died in Kurukshetra war? 1.6 billion? COVID 19 has so far killed 500,000 and includes doctors and nurses. Kurukshetra war killed ‘very fit warriors’, whereas COVID is killing mostly very vulnerable ones although some fit ones are involved. So, how did this enemy COVID emerge? What is it that the general public can do to fight this and help doctors and nurses? How can Bhagavad Gita be a Medicine?
The Coronavirus is believed to have
originated in bats, and these infections have been transmitted directly to
humans from wet markets of Wuhan, China, although this is not 100% confirmed. There
is trading of wild life in these markets. This is of ‘tamasic nature’ and has
been condemned in ‘Bhagavad Gita’
The public should consider the health not just of humans, but of animals and
the environment, to avert future crises. Science tells us that the destruction
of ecosystems makes disease outbreaks including pandemics more likely. This
indicates that the destruction of nature
is the underlying crisis behind the coronavirus crisis.
Also, throughout Bhagavad Gita you will see the word ‘Shoucham’ (cleanliness) mentioned a number of times. Just to quote one:
deva-dwija-guru-prājña-
pūjanaṁ
śhaucham ārjavam |
brahmacharyam ahinsā cha śhārīraṁ tapa uchyate ||17-14 ||
[1. Austerity of the body is said to consist of worship of the gods, Brahmanas, teachers and wise men; cleanliness, honesty, celibacy and not harming (ahimsa).]
Bodily
tapa consists of cleanliness – hand washing, etiquettes in coughing and
sneezing, clean clothes, dispose of tissues, maintaining social distance etc.
Various countries have imposed a strict ‘lockdown’ of their cities. This
measure, besides containing the spread of virus also contributes to a large
extent, with, control of senses of individuals. Bhagavad Gita has been a great
advocate of Indriya Nigraha (sense control) and this is so much valid in
current COVID crisis. It is important that people do not stock pile food, do
not visit cinemas, shopping malls, hotels etc. and control their senses and show
their wisdom
yadā sanharate chāyaṁ
kūrmo ’ṅgānīva sarvaśhaḥ
|
indriyāṇīndriyārthebhyas tasya prajñā pratiṣhṭhitā
||2-58 ||
[When
a person withdraws all his senses from their objects, like a tortoise
withdrawing its limbs, then his wisdom is firmly established.]
I understand it has been difficult for people with temples being closed for
public. In a way, this is self-inflicted by public. People crowding in massive
queues for darshan, falling and pushing on each other, coughing, spitting and
sneezing without etiquette and sometimes losing patience and getting angry in
front of the very presence of GOD, it makes you wonder about the sanctity of
the place. It is best to ban such gatherings. Public should have some sense of
decor with bhakti to get the serene darshan of GOD.
So, I come back to my question as to how much people should be worried about the current COVID crisis. Should they be worried? People who have firm faith in God and spiritual understanding should be least worried. The ‘one’ sitting inside your hearts will give you protection – innate immunity.
ahaṁ vaiśhvānaro bhūtvā prāṇināṁ deham āśhritaḥ |
prāṇāpāna-samāyuktaḥ
pachāmy annaṁ
chatur-vidham || 15-14 ||
[I become burning energy Vaiswanara within the bodies of the living beings. By
combining with the prana and apana breaths, I digest the four types of food]
When Krishna says that he is present within the body, as the vaishvanara energy that digests food we should understand that it is the energy of God that sustains the material world and enables it to nurture life, and it is in this sense that God pervades this world. It is in this sense Lord Krishna will protect everyone in this crisis.
This pandemic has led to economic crisis. However if there was spiritual globalization, there would have been sustained economic globalization and economic growth. This is a famous quote of the Puthige Matha Pontiff Sri Sri Sugunendra Teertha Swamiji. Spiritual globalization will also serve a big role in avoiding pandemic crisis. From the perspective of the doctors, nurses and healthcare workers – what is the inspiration they should derive from Bhagavad Gita? The following quotes are very strong and very inspirational.
hato vā prāpsyasi swargaṁ
jitvā vā bhokṣhyase mahīm |
tasmād uttiṣhṭha kaunteya yuddhāya kṛita-niśhchayaḥ ||2-37 ||
Either you will die and reach heaven or
else you will conquer and rule the earth. Therefore arise, Kaunteya, with your
resolve set on battle.
There is no choice for doctors, nurses
and healthcare workers other than to do their duty. They should do it with
selflessness and devotion. The ‘Dharma’ of doctors need to be fulfilled as
Arjuna fulfilled his Dharma as Kshatriya. Therefore they should arise with
their resolve set on defeating COVID. They should trust lord Krishna and He
will take care of them in the same way, He looked after Arjuna. Wherever there
is Lord Krishna there is always victory! Let there be no doubt about this. The
Bhagavad Gita quote goes as follows:
yatra yogeśhvaraḥ kṛiṣhṇo
yatra pārtho dhanur-dharaḥ |
tatra śhrīr vijayo bhūtir dhruvā nītir matir mama || 18-78 ||
[Wherever there is Krishna, the master of yoga, and wherever there is Partha who bears the bow, there will also be good fortune, victory, success and good judgement.]
Worship of Lord Krishna with utmost faith and devotion is the need of the hour as this is only certain medicine which is going to protect all of us! The Bhagavad Gita quote says it all:
ananyāśh chintayanto māṁ ye
janāḥ
paryupāsate |
teṣhāṁ
nityābhiyuktānāṁ yoga-kṣhemaṁ vahāmyaham || 8-14 ||
Lord Krishna says - persons who worship me with undeviating concentration, for those who engage in me constantly, I bring both prosperity and security to them! Every medical doctor has taken an oath to care for patients to the best of their abilities.
Now, as doctors turn that promise into action, they should push through the mental and physical exhaustion in order to help the growing number of patients who fill our hospitals. I can see this pledge in the eyes of masked doctors and nurses across the world, as they treat patients without hesitation, no matter how mentally or physically draining it may be. I pray Lord Krishna to help them all.
I
finally end my article with the famous quote of Bhagavad Gita:
paritrāṇāya
sādhūnāṁ
vināśhāya cha duṣhkṛitām |
dharma-sansthāpanārthāya sambhavāmi yuge yuge || 4-8 ||
[For the protection of the righteous (sadhus), for the destruction of the wrongdoers and for the purpose of establishing dharma, I appear age after age.]
Krishnarpanamastu!
[Submit everything to the Supreme Lord! He will take care of you!]
The relevance of the Bhagavad Gita for modern psychotherapy has been widely reviewed. However, relatively little empirical literature exists on the effectiveness of versus spiritually integrated psychotherapy incorporating Hindu psychotherapeutic insights. Clearly, more work is needed, and COVID-19 may provide an opportunity for conducting further empirical research. In the meantime, it can be seen that by using the principles outlined here may already be of benefit in helping those in need, and may be rapidly enabled in the emerging era of telehealth and digital health!
Emerging pandemics show that humans are not infallible and communities need to be prepared. Coronavirus outbreak was first reported towards the end of 2019 and later declared a pandemic by the World Health Organization. Worldwide countries responded differently to the virus outbreak. A delay in detection and response has been recorded in China, as well as in other major countries, which led to an overburdening of the local health systems. On the other hand, some other nations have put in place effective strategies to contain the infection and have recorded a very low number of cases since the beginning of the pandemics. Restrictive measures like social distancing, lockdown, case detection, isolation, contact tracing, and quarantine of exposed had revealed the most efficient actions to control the disease spreading. Based on the experience of these countries, India responded to the pandemic accordingly and was also spiritually guided by scriptures like Gita. Hindu rituals call for body and space cleanliness all the time (aachaara vichaara). Only time will tell how well India has faced the outbreak. We know the recovery to normalcy has been faster in India though it is heavily and densely populated. It will be beneficial for global community to focus on EQ and SQ Management, particularly during Pandemonium
Let us show our gratitude to the physicians and other healthcare professionals for their dedication to the nation, for helping all to cope with the situation, guaranteeing the wellbeing of all and pray to Lord Dhanvanatari for their long and healthy life to serve humanity!
