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Cross-Cultural Psychology

How Buddha's "Right View" Cultivates Compassion

Let’s shape a healthy healthcare culture using Buddha's Eightfold Path.

Key points

  • The first step of the Buddha’s Eightfold Path, "Right View," is a guiding principle for healthcare providers.
  • Right view is a compass, helping healthcare professionals focus on relieving suffering and having compassion.
  • Traditional methods of medical teaching involve fear and humiliation and contribute to burnout.

Part 1 in an eight-part series.

As with any journey, a starting point is essential. It's like having a compass in hand, knowing where to place our feet and which direction to head. The "Right View" or "Skillful View," the first step of the Buddha's Eightfold Path, becomes our guide. It's the map for navigating the "inner wilderness" of challenges in healthcare and within ourselves. While the subsequent seven steps act as tools to "clear the path," the right view provides a crucial frame of reference. It keeps us focused on the ultimate goal: Liberation from suffering and discovering our best selves, supported by the pillars of compassion and wisdom.

Sounds easy enough, right? Not so, unfortunately. Not all views are beneficial, and we need a way to gauge which views will be helpful to us and which ones are not. I would argue that healthcare providers, especially doctors, are set on a path laden with unskillful views from the very start of our training, and this is a road that leads to much suffering. What makes these views so hard to detect is that they are embedded and habitual—even hidden—but sewn into the core view of the medical profession. What do I mean by this?

As a medical student 25 years ago, I learned early on that being a doctor is a hard life and that this suffering was rewarded. I saw this in the faces and hearts of the more advanced medical students and the resident doctors. Our basic needs—sleep, nourishment, exercise, relaxation, and rejuvenation—are not supported.

Much of the teaching was built on fear and humiliation. Remember the dreaded "pimp sessions" on the medical wards? This terrifying act of verbally quizzing a student doctor in front of an audience was supposed to "keep us on our toes," I suppose. In contrast, realistically, it sent most of us into the basic trauma response of "fight-flight-freeze."

This view of teaching new doctors has been handed down through generations (generational trauma, anyone?) In recent years, there have been some direct changes towards the number of hours a resident can work, which is now limited to 80 hours, and a single shift cannot extend more than 24 hours (3). While this is a nice gesture, it doesn't really get to the heart of the problem: The culture of medicine has not been built using the facets of "Right View."

The roadmap that we follow leads many on the path directly to suffering, which is exemplified by the doctor burnout crisis, a decline in mental health, and a mass exodus of many of us from the field of medicine itself (4). Ironically, a profession that tries to alleviate the suffering of patients creates a great deal of suffering for those providers of care.

As a student in the Contemplative Care Fellowship at the New York Zen Center, I am learning how to untangle that unskillful view from that path many of us healthcare workers have spent much of our lives treading and then wondering why I feel so empty and unhappy. While changing the current culture of care is no easy feat, we can start by making a change inside ourselves: one of self-compassion and true human worth.

Setting this groundwork and speaking and acting against the old "unskillful" view of medicine can make an impact, for what we say and do does not exist in a vacuum, and compassion can be catching. And positive relationships—ones built on respect and support instead of humiliation—do matter. Some studies show that creating a compassionate workplace culture eases burnout and leads to more job satisfaction. These same studies also show evidence that compassion improves mental and physical health, improves professional success, and positively affects longevity (1).

So by embracing the right view, the first step on the Buddha's Eightfold Path, we are cultivating our inner goodness that helps make how we are in the world as important as what we do. This is an important ground as we next explore "Right Intention," which takes the roadmap we created with "Right View" and sets it into motion.

References

1. Compassionomics - The Revolutionary Scientific Evidence That Caring Makes a Difference. Trzeciak & Mazzarelli. 2019.

2. Steps to Liberation - The Buddha’s Eightfold Path. Gil Fronsdal. 2018.

3. https://psnet.ahrq.gov/primer/duty-hours-and-patient-safety

4. Scott W. Yates. Physician Stress and Burnout. American Journal of Medicine Volume 133, Issue 2, P160–164, February 2020)

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