In Exile From the Land of Snows

by John Avedon

  Only two other doctors had escaped from Tibet, neither of whom could assist Dr. Dhonden in Dharamsala. Alone, he began to train ten students in the rudiments of his science, their progress hampered by an almost total lack of funds. Yeshi Dhonden could do little until, one day in 1963, his many run-ins with Indian doctors yielded an ironically positive result.

  Responding to repeated complaints from local physicians that the Tibetan was “stealing” their patients, a senior minister in the Indian Health Department arrived in Dharamsala to investigate. For a week he watched Dr. Dhonden diagnose patients by their pulse and urine, after which he carefully asked each individual his ailment. At one point, five officers from the nearby army cantonment came in to refill prescriptions. “When the minister saw them he exploded in a rage,” recalled Dr. Dhonden. “ ‘We give you the best health care in India and now you’ve come here to eat shit from a Tibetan!’ he yelled.” The officers replied that in many cases they had been ill for fifteen years or more. Where Western medicine had failed, Tibetan medicine had succeeded. “Unlike other doctors,” they said, “we don’t have to tell Dr. Dhonden what’s wrong. He tells us.” The day before he departed for New Delhi, the minister came to Yeshi Dhonden’s office. “You are doing very good work here,” he said. “There is only one problem. You don’t have enough students. I’m going to give you thirty thousand rupees a year and a twenty-bed hospital.” In this manner, the Tibetan Medical Center was formally organized.

  Dr. Dhonden assumed the roles of director and pharmacologist as well as chief examining physician. In 1965 he was joined by a second physician, who assisted in teaching the now seven-year curriculum, leading expeditions into the mountains behind Dharamsala to collect herbs and manufacturing 165 principal drugs. With 15 students graduating to join the 150 or so doctors practicing Tibetan medicine outside of Tibet and plans underway for a research wing, a museum and nine outpatient clinics in the settlements, Dr. Dhonden resigned from the Center in 1969. Opening a private practice in McLeod Ganj, he continued to see the Dalai Lama, taking his pulse each day just after sunrise, until in 1978 another physician was appointed to assist him. Dr. Dhonden was then freed to introduce Tibetan medicine to the West.

  “THE INFORMATION REQUIRED before Tibetan medicines could be approved for use in the United States would take an army of lab technicians years to develop,” commented Dr. Gerald Goldstein, speculating on the future of an exchange between Tibetan and Western doctors as Yeshi Dhonden’s visit in Virginia drew to an end. “Each ingredient must be individually identified, purified from its crude state and then thoroughly tested. Who is going to pay for it?” “Research today is a cost-benefit situation,” concurred Dr. Donald Baker. “How is a drug company going to collect all of these medicines in northern India and still make a profit at it?” “The impetus for the work, though, is clear,” added Dr. Goldstein. “Over one third of our pharmacopoeia comes from plants and microorganisms, specifically some of our oldest and most effective cancer drugs. These are just the sort of materials Tibetans have acquired experience with over centuries of use. Personally, I think the drug companies are missing a bet. Some of these medicines are definitely going to be active.”

  In the East, the bet has not been missed. Whereas Peking destroyed every institution of the old Tibet soon after 1959, it preserved and later expanded Mendzekhang. Now called the Hospital of Tibetan Medicine, Mendzekhang’s 127-member staff treats 700 to 800 patients a day. Though the doctors have been forced to curtail their unique knowledge of the mind’s relation to the body (considered, as a basic component of Buddhist teachings, anathema), volumes of color photographs cataloguing medicinal plants have been compiled, while many of the most valuable herbs indigenous to the Himalayas have begun to be cultivated on high-altitude farms. Concurrently, Tibetan drugs are in widespread use throughout mainland China though they are referred to as Chinese in origin and not Tibetan.

  “Tibetan and Western medicine begin from completely opposite standpoints,” said Dr. Dhonden, summing up his view of the two sciences after visiting the United States. “To start with, a Western scientist looks through a microscope to examine the cause of a disease in terms of its molecular particles. Only then does he take into account the particular patient. Tibetan doctors begin with the patient. We consider his disposition in terms of wind, bile and phlegm. And then we approach the disease. The difference, I feel, makes for weakness and strength in both. We lack many of the symptomatic treatments modern physicians possess. On the other hand, it would be useful for Western doctors to understand the Tibetan presentation of the humors, their balance and imbalance in the human body. Without this, their medical system remains incomplete. It cannot establish a clear view of the correct causes and conditions governing all disease. If young Western doctors would come and train with us for a period of years—as well as relating their own system’s analysis of disease—then, I feel, a true exchange could occur. So each of us it seems,” he concluded, judiciously, “has something of value to learn from the other.”

  7

  On Pilgrimage with the Dalai Lama

  NIGHT BLACKENS PATHANKOT. Headlights swerve across the buckled row of wood stalls lining one end of the main road. Inside, chilled keepers sit on platforms buried in unbought goods: old blankets, used rubber boots, discarded greatcoats from the nearby army base. Lighted by single bulbs dangling over their angular heads, they gaze balefully into the dark street. Even at night, its chaos refuses to subside. Tattered coolies, rearing up on bicycle rickshaws, press into the middle of the road in the trail of a bus, ignoring fierce horn blasts from the next, coming up behind. Dented, scarred Ambassadors, India’s domestically manufactured car, jockey for position. From opposite directions they speed at one another down the center of the road, their drivers veering at the last instant only to avoid collision. The Tatas, towering diesel-powered trucks, festooned with somber portraits of blue- and red-faced deities illuminated by colored bulbs and framed with tinsel, supersede the bluffing. Refusing to slow for the town, they plummet through, horns blaring, spraying the road with fumes. In their wake hundreds of men, wrapped in shawls against the early-January cold, dash across the avenue. Obscured by the dark and even after a rain, the dust rises around their thin legs. As it clears, the scene behind appears. Scores of cubbyhole-sized repair shops specializing in one aspect of a vehicle—tires, radiators, fenders or batteries—have thrown their contents onto the open ground before their doors. While the older drivers of berthed trucks huddle about fires in trash cans, smoking leaf-wrapped bidis, gaunt young men clad in pajama-like pants, arms and faces black with grease, rush feverishly from part to part searching for any small item, of rubber, steel, black iron or wood, that might temporarily serve as a facsimile of a functioning thing. But the decay is irremediable. The very elements of this world, it seems, have devoured their vital force long ago.

  Tibetan sweater sellers strike out from their few shared homes, through the town, to the old British-built train station. Passing the dry fountain in its muddy courtyard, they walk beneath the grand pillars of the portico into the main hall leading to the tracks, bounded left and right by ticket windows, now closed. Here they quietly form two facing rows, a broad aisle in between. The women wear ankle-length robes and rainbow-hued aprons, their black pigtails braided with ribbons; the men are in hiking boots, slacks and red or blue parkas. Bundles of incense are ignited. In a corner three nuns, their palms pressed together, recite prayer aloud. A man in a dark suit enters, followed by a troop of bearded Sikhs dressed in olive coats and blue red-finned turbans, bandoliered with cartridges and carrying massive, wooden-butted rifles—the Punjabi police. Mr. Dhawan, New Delhi’s liaison officer to the Dalai Lama, proceeds slowly down the aisle. The crowd stiffens; there is a rustling of newspapers and in a dozen places bright bunches of pink, red and yellow plastic flowers materialize, making the hall suddenly jump to life.

  A red light spins across the dark beyond the fountain. A jeep swoops up between two pillars, em
itting a squad of police, who, flanking out, screen the station’s entrance. It is followed by a maroon Mercedes-Benz which drives directly onto the marble floor of the hallway. Before the vehicle has stopped, its back doors are flung open, and Ngari Rinpoché, the Dalai Lama’s younger brother, accompanied by a monk and a Tibetan bodyguard, leaps out. Now that he is in his early thirties, Ngari Rinpoché’s great physical resemblance to the Dalai Lama conveys such authority that as he strides into the hall the Tibetans bow as one from the waist, audibly suck in their breath and distend their tongues in the traditional sign of greeting. The front door of the Mercedes opens and out steps the Dalai Lama, clad in burgundy robes and brown oxfords, a maroon monk’s bag slung casually over his right shoulder. Bent slightly from the waist, palms clasped before his chest, he walks slowly down the aisle, his features composed, eyes lit with a warm humor, making contact with scores of expectant faces. Led by Mr. Dhawan, he turns left at the tracks, his retinue sweeping along behind, and heads for the “Retiring Room” to await the train. Ebullient from their brief glimpse of the “Wish-Fulfilling Gem,” the crowd breaks and scatters down the platform after him, racing past a sign which optimistically reads: “Trains may either gain or lose time.”

  In half an hour, a black barrel-nosed steam engine, pulling a long rust-colored train, groans into the station from Jammu, the railhead two hours north of Pathankot. Called 33 Down, for its west-to-east direction down and across the breadth of northern India, the train contains a private saloon. Its exterior is worn and dusty like that of the other cars, the windows tightly shuttered by silver metal blinds; the interior, however, is equipped with a modern sitting-dining room and crisply made-up sleeping cabins, staffed by its own cook and servants who wait for their guests in a white-jacketed line, grinning nervously before pots of steaming water on the kitchen’s iron stove. Crossing the short interval of platform, cleared by police of vendors and beggars, the Dalai Lama enters his car. It is already nine o’clock, and because he normally rises at five to meditate, he goes immediately to his room to say evening prayers and retire for the night. The nine-member entourage—four monks, two bodyguards, two officials of the Indian government and Ngari Rinpoché—choose cabins and sit for a late dinner. Within ten minutes the train pulls slowly out of Pathankot on its way across all of India, taking the party far to the east to Bihar, the first stop on the Dalai Lama’s 1981 pilgrimage to the holiest sites of Buddhism.

  For two days and nights, 33 Down traverses India. It is a local. It stops in every town, never running for more than an hour without break. As the cars turn south in a broad arc the first night, white clouds of steam and soot billow back from the locomotive across their flanks, shuttered against the northern cold. Inside, it is—for India—eerily silent. At the start of its trip the train is virtually empty. In second class there is room to spread out in the three-tiered cubicles sectioning the interior like human storage racks. The private compartments of first class are deserted. Jullundur and Ludhiana pass in jolting, chaotic pictures, scored by train whistles, couplings and porters’ shouts. Between, the dark land stands cold and still. By dawn, having crossed the Jumna River on the way down to Delhi, both the Punjab and Haryana have been left behind; Saharanpur and then Moradabad are reached, well within the line of Uttar Pradesh; with 100 million inhabitants, this is India’s most populous state and among the most crowded pieces of land on the planet. The train is no longer empty. Every car save the Dalai Lama’s saloon is jammed. In second class there is no longer room to stand. Passengers hang off the uppermost bunks, clutching caged fans in the ceiling to keep their balance. Below, twenty-five people, packed in an area the size of a meat locker, shout, laugh, peel eggs, belch, play cards and chew betel nut, leering with bright red tongues and wet lips when they win a hand. Now the metal shutters have been pushed up as far as they will go, the cold of the mountains left behind, any breath of air welcomed to relieve the heat and sweat-filled atmosphere of the car. Even first class has not escaped the crowds. India’s commuters, university students and businessmen, pour on to travel a half hour from one town to the next, up to twenty at a time boisterously filling compartments booked for six. The conductors are gone.

  Rampur, Shahjahanpur, Sitapur, Lucknow, Rae Bareli, Jais, Amethi, Bela … The countryside is one. As the sun shoots up a hundred miles to the north over the distant Himalayas, touches its low winter noon midway in the sky and falls down to the right of the train, its flat light blandly pans through a hazy white sky. A maze of small dusty green rectangles, demarcated by two-foot-high gray mud walls, sit flush on an interminable plain, choking the level land: India’s exhausted heart. Save for sudden wastes of sand or wide, dry riverbeds, every inch of earth is cultivated, the soil overworked and depleted. Few people, though, are visible in the fields. They come into sight at the brick factories bordering every town. Here the earth has been dug three or four feet down, exposing a brittle texture and a flinty, barren hue. In the midst of acres of stacked bricks stand twin funnel-shaped chimneys, the tallest points on the treeless landscape, resembling ruined pillars, their blackened spouts decapitated. Around the kilns at their base trudge the emaciated sari-clad bodies of women workers, flat bare feet and bony ankles wrapped in their greatest possessions: bulky, shackle-like bronze bracelets. The towns come on in choked pools of urine-soaked pea-green slime, their surfaces littered with paper, feces and trash, backed up against low walls scrawled over with political slogans and papered with torn lurid movie posters. Behind each, a chaos of cattle, traffic, compressed buildings and roads, spreading like broken veins, consumes the thin line of rail as it passes the outskirts and comes to a halt in a station. The full spectacle of society then appears, trooped out on the platforms. At one in the afternoon scores are asleep, wrapped in blankets side by side, their heads on their baggage. Before the engine halts, young vendors wash up against the cars bellowing in stentorian voices, “Moongphali! Moongphali!” (“Peanuts! Peanuts!”). Others hawk vegetable fritters, fruit, chapatis and milky tea in brown clay cups which, emptied, are thrown on the tracks and smashed. Muscular porters—sporting polished brass badges on red coats over their dhotis—hurl through the crowds, huge trunks balanced on their shoulders, the owners racing behind so as not to lose their luggage. The wealthy cut through the sea of poor making for first-class cars, where their names are posted on cyclostyled pages by the doors. As the reckless exchange between those embarking and those disembarking subsides, the broken bodies of beggars appear on the ground near the public fountains, where, twenty-four hours a day, a new group of risers are brushing, hacking, splashing and spitting, eager to feel fresh.

  The second night. In the Dalai Lama’s car, the quiet that has characterized the journey so far continues. The rear door locked, a bodyguard sits near the front monitoring the rare comings and goings at stations. Mr. Dhawan and Dawa Bhotia, Delhi’s chief of security for the Dalai Lama, occupy the sitting room with Ngari Rinpoché, talking shop, smoking and reading newspapers. Lobsang Gawa and Paljor, the Dalai Lama’s two personal attendants, who were chosen by him years before as young men from his private monastery, Namgyal Dratsang, occasionally pass some hours in the room joking with Ngari Rinpoché and the guards. The Dalai Lama himself leaves his cabin only to wash, taking his meals alone. He has spread a large orange and yellow cloth-bound scripture across the desk top beside his portable shortwave radio, tuned in the morning and evening for international news. Certain of Tibet’s most sacred images, believed to be receptacles for divine protectors and always kept in the company of each Dalai Lama, are placed about the cabin.

  Outside there is actual danger. Murdering “dacoit” bands, equipped with homemade “country” pistols, proliferate in the area. Unseen in the dark, the populous flats have given way to wild hills and gullies out of which the dacoits issue forth to hold up trains, hijack trucks and raid villages. Ironically, due to the great crowds, second-class passengers are safe. First class, with its private compartments and richer take, is the prime target.
Here the passengers have locked their doors and refuse to open them without questioning all callers. At 4:00 a.m. Benares, the Holy City, is reached. Half the train exits; some have come to die by the burning ghats on the Ganges’ shores, their long flames fueled for millennia by generations of the Hindu race. Beyond Benares the Ganges is crossed and the very heart of ancient India, Madhyadesa or “the Middle Country,” spanning the Gangetic plain, is entered: the land of two kingdoms and nine republics forming the core of the Buddha’s world. And then, by eight-thirty on the morning of the second day, the train finally reaches Gaya, six miles from Bodh Gaya in the state of Bihar, the site of the Buddha’s enlightenment, the axis mundi of the Buddhist faith.

  In the midst of a seemingly endless succession of stops, arrival comes as a surprise. There is a quiet around the Dalai Lama’s saloon. The windows and doors remain locked. On the platform, the abbot of the Tibetan monastery at Bodh Gaya waits in a small group of monks. Their neat claret robes and bright yellow jerkins form a clean, tranquil pool of color in the stream of stained and torn figures swirling around. The front door of the saloon gingerly opens, and Ngari Rinpoché looks out. He pulls the door back and the monks are ushered in, bearing white silk scarves, to welcome the Dalai Lama. After a brief greeting in the dining room, the Dalai Lama briskly leads the party back out, not wishing to lose time.

  There is something different in Gaya. It is apparent on the platform, in front of the station house, even before the town itself is reached. There are crowds, but their movement appears frail and somber. The frenetic pace has not slowed, yet its interior force has dissolved. The people abut one another more lightly, their appearance shrunken and strained. There is, as well, a less subtle sign of the change. As the Dalai Lama steps out of the saloon and walks toward a covered bridge spanning the tracks to the station house, he passes a small girl, no older than eight, alone on the platform. Unlike other beggars in other stations, she says nothing at all. She stands immobile in a torn gossamer rag, a glassy look in her dark eyes. The girl is severely starved. Her black matted hair is light red from protein deficiency. Her nose, jaw, shoulders, bare legs and arms are flat bone. The slight bulge of her lips forms the only fullness on her body. The quick movement of the large party passing by pulls her little head up, mouth drawn tight, forehead pinched at its center. Automatically her hands, holding a tin bowl, extend. Already past her, the Dalai Lama calls for Ngari Rinpoché and instructs him to return and give the child money. He drops behind, finds her and, bending down, speaks. The girl grabs the twenty-rupee note he has offered; twenty rupees—$1.66—eighty times the bunch of coins—twenty or thirty paise—normally given. Later Ngari Rinpoché himself is surprised—even appalled—over his recondite breach of the conduct governing the normal business done between beggars and donors.