Working in a Hospital

By Kyabje Lama Zopa Rinpoche

An interview with Kyabje Lama Zopa Rinpoche on 23 August 1998, regarding work with sick and dying people in hospital. The interview transcript is lightly edited by Sandra Smith.

See Rinpoche's Online Advice Book for more advice on practices for healing. Read more articles about death and dying in Preparing for Death and How to Enjoy Death.

Lama Zopa Rinpoche at Chenrezig Institute, Australia, 1991. Photo: Thubten Yeshe.

Student: Do you have any specific advice about using the experience of working in a hospital to develop renunciation?

Rinpoche: The hospital is unbelievable. You see people dying there or suddenly having a heart attack, especially in places where people have heart problems. They have to watch the machines all the time, and the doctors and nurses all come running [if there’s a problem.] I know from when Lama was in the hospital in California, they were constantly watching the machines and whenever anything happened, they would all rush in.

The hospital is a very intensive teaching that shows death can happen at any moment. What happens to the patients can happen to us at any time. We have to think this way. When we look at animals, we think, “I’m a human, they’re an animal and there is no connection at all.” We never think, “I have been like this numberless times in the past, and I will become like this if I don’t purify my karma.” Normally, we don’t think like that, but in reality, we have been like that numberless times, and if we don’t purify our karma, we will be like that in the future also.

In the hospital, we shouldn’t think, “These are the patients and I am a healthy person.” We should think, “So many negative karmas have been collected in the past, so these things can happen to me.” If we do not purify and we endlessly create more negative karma, we will experience these things. We have already experienced things like this numberless times in the past, and we will experience them again in the future if we don’t purify our negative karma and get liberated from samsara, which means getting liberated from delusion and karma. That can happen only through the practice of Dharma. As long as that doesn’t happen, these things will be experienced without end. There is no end to these sufferings.

So in the hospital, Dharma practice becomes unbelievable. Dharma practice is the most important thing in our life, and its foundation is renunciation. In our Dharma practice, bodhicitta brings the most benefit. Everything can become an inspiration for us if we think that we have been like the patients in the hospital numberless times, because of karma. Think, “If I don’t purify my karma, I will experience things like this without end. Therefore, I must practice Dharma, and I must practice not just renunciation, but also bodhicitta.”

[To help] someone who is experiencing strong pain, visualize AH in the palm of your hand, however you need to have received the Chenrezig initiation. Visualize yourself as Chenrezig and place your palm on the part of the body where the person is experiencing pain. One way to do this is by thinking that the AH sucks all the sicknesses, the spirit harms, the defilements, the negative karma, everything, and it is absorbed by your ego; it completely destroys your ego. So in this way you are using all of their suffering to generate bodhicitta in your mind, by destroying the ego. You are using that as medicine to heal all the chronic disease of the ego—that condition which has no beginning and has harmed you from beginningless rebirth.

Do this to develop bodhicitta, so that you can become enlightened, and so that you can enlighten all sentient beings. While you’re doing this, you can recite mantras, verbally or just mentally. Press stronger and stronger on that spot for about the duration of one mala, although you can do it for longer. The other thing is that the same things from the person’s heart… [tape unclear]…the person’s body becomes totally illuminated. So these four things—sicknesses, spirit harms, defilements and negative karma—become completely purified and the whole body becomes in the nature of light.

With most sicknesses there is a connection with the spirits—with the person’s karma and with spirit harm. There are many different pujas where you can make a figure—a doll of the person or a substitute — and offer it to the spirits, while saying, “How beautiful, how gigantic, filled with oceans of nectars, and all the wish–fulfilling things, whatever the spirits want.” So you make them satisfied, you make them happy. After that, ask them to do charity. Explain Dharma to them and ask them to set the person free. Ask them to subdue their minds and teach them about bodhicitta. Then ask them to leave.

There is a practice call chöd, slaying the ego. It is a practice to quickly realize emptiness and bodhicitta. While you are doing this, give your body to the spirits on behalf of the patients. Then the spirits get mountains of meat, of your flesh, to eat completely, and to drink your blood. They become fully satisfied, so they can generate bodhicitta and then they leave. This is a very good practice for you. This is a very good bodhicitta practice, renouncing oneself and cherishing others. So it is very good for you and for the patients. There are different mantras to recite. If you do this very sincerely, with much compassion for the spirits and the patients, then you can stop some heavy pain.

While you are doing this, you can recite OM MANI PADME HUM or Hayagriva mantra. Hayagriva is very powerful for healing. There is another mantra1 used by some great healers that goes with the practice I described earlier, where you visualize AH on your palm. It is said that this mantra should come with a gold offering. It comes from Padmasambhava and it has unbelievable benefit. Many great healers use this mantra for healing all the sicknesses. It says in the text that without a gold offering, you cannot give this mantra because it is so powerful.

Student: Please give advice about working in hospitals with sick people who are experiencing physical or mental suffering and fear of death. Also, please give advice about helping relatives who have to decide whether to continue treatment or let the sick person die.

Rinpoche: If you are able to help sick people go to the pure lands that is a good way to help them overcome death, because in the pure lands they can complete the path and become enlightened. Without actualizing the path there is no way to overcome death—we have to reach a certain level of the path to be able to overcome the experience of a normal death.

The Hinayana paths are all to reach arhatship and only after completing these paths are we free from the cycle of death and rebirth. Then on the bodhisattva path to enlightenment, the Mahayana path, we experience no more death only after we reach a certain stage. In Highest Yoga Tantra, there is the generation stage and the completion stage. The generation stage has two levels, gross and subtle, and the completion stage has five levels. If we achieve these levels, then we are free from death. So we have to reach a certain level of the path to overcome death.

The quickest way to help these sick people would be if you could cause them to go to the pure land. That means also from their side they have to have the merit to go to the pure land. Not every pure land provides the opportunity to become enlightened. To become enlightened in the pure land means there must be the opportunity to practice tantra there, but not every pure land provides the opportunity to practice tantra. In Shambala, Heruka or Vajrayogini pure lands, we definitely have the opportunity to practice tantra, so we can become enlightened in those places. The great advantage of being reborn in those pure lands is that we can definitely become enlightened in that life.

My first suggestion would be for you to recite ten malas of OM MANI PADME HUM first thing in the morning. Then your body becomes so blessed, it becomes really holy, and anybody who touches you or whom you touch—even if you just shake their hands; even insects—all get purified. Their karmas get purified and this gives them the opportunity to have a good rebirth. So whenever you touch sick people, it purifies their negative karma. It is said by Buddha that there are infinite benefits of reciting this mantra, one could never finish explaining the benefits of reciting it.

It is said that if you recite ten malas in the morning and go into the water, your body is so blessed that the water that touches your body also becomes blessed; it becomes like holy water. So that water then purifies all the innumerable numbers of insects in the water and also the people who swim there. Whoever the water touches, it purifies all those beings, so it is said that the benefit is unbelievable.

It is said that if you recite ten malas a day, then your children and your children’s children, up to seven generations of your family, will not be reborn in the lower realms. This is because they are all a continuation of your egg, blood or sperm, and your body is so blessed. So if your descendants have virtuous thoughts when they die, then it will help them avoid being reborn in the lower realms for up to seven generations.

Also, when the person who recites ten malas a day dies and their body is burned, this will purify the karma of anyone who breathes or touches the smoke from that fire, and they will not be reborn in the lower realms. So this is a very good thing to do, especially for someone working in the hospital. You can say the mantra at home, but then just touching the patients will benefit them.

The other thing you should do is the Medicine Buddha practice. Recite their names and the mantra every day, and pray to the Medicine Buddha, saying, “Anybody who sees me, who touches me, who remembers me, who thinks about me, who talks about me, may all those beings never be reborn in the lower realms ever, and may they immediately be liberated from all the disease, spirit harms, the defilements and the negative karma.” Think especially about the people who are possessed by spirits, because they are so difficult to help. Usually, we can’t help them until the person’s karma finishes. In some cases we can help, but the person needs some merit from their side. So think about those difficult cases and think about the people who are in a coma, who have AIDS or cancer; all those difficult cases. Pray that those people may be immediately relieved from their heavy sicknesses.

For those people who die, pray that if they think of you or remember you as they are dying, they will experience incredible bliss, incredible joy, and they will have no fear at all. Pray that their consciousness will immediately be able to transfer to the pure land where they can become Buddha, where they can become enlightened.

Every day you should pray to the Medicine Buddha like this. The Medicine Buddha did a lot of prayer and dedications before he became enlightened. Because of that, if you say the Medicine Buddha mantra, those who pray for good things to happen, for problems to go; those who say prayers, will receive results. Not only that, but they will become enlightened themselves. Buddhas have the qualities of ten powers, and the last one is the power of prayer. So because they achieved the power of prayer, it is very powerful if you pray to them, and the prayers will be actualized. If you pray to them, then what you pray for, you will receive. So recite the Medicine Buddha’s name and mantra. You can also get the Medicine Buddha text. I translated a book many years ago at Kopan with this practice. You can get the names of the Medicine Buddha from this book.

This question of whether to “pull the plug” or to leave people dependent on machines is a big problem in the West. According to Kirti Tsenshab Rinpoche, there is so much hope by keeping the person alive, even though there may not be much chance for the person to recover. However, it may cause a lot of troubles to the family and a lot of expenses, and it may cause problems for many members of the family, so in that case, it may be better to pull the plug.

These people are very lucky to be cared for by a Buddhist nurse, especially one who practices tantra. They are lucky they can receive prayers from you. As a Buddhist, you will do the correct prayers. Some others may pray, but their prayers may not be correct. The Medicine Buddha practice is very important, so chant the name and the mantra. That also helps whatever you pray for in your daily life to become actualized. So it helps not only the patients, but it also helps you and other sentient beings.

While you are with the patients you can just sing songs—sing the Medicine Buddha mantra or OM MANI PADME HUM. The patients may be of other religions or they may not be religious, so you can just sing the mantras like a song, then they think you are just singing to make them happy. Chant as if you are singing a song, as though to comfort them. When they hear this, it will plant the seed to enlightenment and it will leave a positive imprint on their mind. Probably for some of these people, nothing else in their life is positive. This may be the only positive imprint they have. Sooner or later, due to this imprint, they may meet the Dharma and actualize the path. Then that ceases the eight defilements and brings them to liberation and enlightenment. Even though the person may be suffering terribly and you may not be able to do anything to stop that right now, still you can plant this positive imprint on their mind. In some ways, the longer they stay in hospital, the more you can benefit them. Think of those things. Also this will help you psychologically, because seeing so much suffering can be very difficult for you. At least you know that if you cannot stop their pain now, you can still offer them incredible long-term benefit. Then you can enjoy the work there.

When there is so much pain, visualize the Medicine Buddha on their heads, take strong refuge and visualize a light coming from the Medicine Buddha’s heart to purify them of these four things: spirit harms, sicknesses, negative karma and defilements. Visualize that these things come out in the form of dirty liquid—sicknesses as pus and blood, spirit harms as snakes, etc. When the person is dying, the best thing to do is to visualize the Medicine Buddha and pray very strongly that they will not be reborn in the lower realms and that they will be born in a pure land where they can be enlightened, or that they will receive a good rebirth, a perfect human rebirth, in their next life. If the person is open to it, you can chant, but otherwise just do this very quietly.

If you are doing po-wa, that transfers the consciousness to the pure land. Even if you know this po-wa meditation and you are going to use this meditation for other people, still you should first do the Medicine Buddha practice, purify them and make strong prayers for them to go to the pure land where they can become enlightened. Then after that, do Amitabha po-wa. This is a special practice for transference of the consciousness to the pure land. If you are a nurse or especially if you are working in a hospice, then it is very good to receive these teachings. Then you have to do the practice of po-wa. First practice for yourself until you get the sign, which means that if you actually do the practice, then you can be born in the pure land. The sign might be pus and blood coming out at the crown, or hairs falling off [at the crown]. In one Nyingma tradition, after the retreat the lamas put kusha grass here [at the crown] and if it goes inside, then they say the person has succeeded in po-wa. If it doesn’t go in, then the person has to do more. Once you have done the practice and had the sign, then it means you can do the practice for others. This is a very good service for others, especially for those who work with dying people.

[Rinpoche then gave the oral transmission of the Medicine Buddha mantra.]  


1 This mantra is not on file. [Return to text]