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Sunday, Aug. 2, 2009
Caring for body and soul
Trained Zen monk Sokun Tsushimoto brings a unique consciousness to his new role as a doctor
By TOMOKO OTAKE
With his shaven head, straight back and deep, calming voice, Sokun Tsushimoto, a newly qualified physician who started practicing at a Tokyo clinic in April, clearly betrays evidence of his long and rich life experience.
Until he set out on his eight-year study/training path toward becoming a medical doctor in 2000, Tsushimoto practiced in an altogether different field — that of Zen Buddhism — in which he had held one of the highest positions in the Rinzai School, one of Japan's two major schools along with the Soto School.
Although he no longer belongs to any Buddhist group, nor has any official status as a monk, the 54-year-old native of Ehime Prefecture in Shikoku still says that he is a priest who also happens to be a physician — not the other way around.
And while Japan has a number of Christian, Buddhist and Shintoist doctors, what separates Tsushimoto from the rest is that he was a high-ranking priest who has spent most of his life being trained in, thinking about, studying and teaching on matters of life and death.
Tsushimoto, born a son of a temple priest in the city of Yawatahama, says that, like many others in similar circumstances, he was drawn by the "gravity" of his family lineage to inherit that profession — just as most Buddhist priests in Japan inherit their jobs, except for a few "outsiders," who feel personally and powerfully drawn to the priesthood.
So, after studying philosophy at Kyoto University, Tsushimoto trained at Tenryuji Temple in Kyoto for more than 10 years, becoming superintendent priest in 1993 at one of 14 Rinzai School groups at age 38.
Already on a fast track, he could have continued his career from there as an elite monk — but he didn't.
Frustrated by his lack of medical knowledge when he tried to help people negotiate the unavoidable process of dying — and faced with contradictions of organized religion, which is often more interested in fundraising and adhering to doctrines than in solving people's real-life needs — he decided to become a doctor so he could look after people in both body and soul.
Over the following six years, Tsushimoto studied at Teikyo University in Tokyo with classmates almost half his age, eventually passing the national exam to become a licensed medical doctor. After that, he had to complete a two-year residency training before qualifying to be a practicing physician. He now works three days a week at Kuramae Internal Medicine Clinic in Tokyo's Taito Ward.
Tsushimoto, who is married and has two school-age daughters, recently sat down for an interview with The Japan Times, to talk about his time as a trainee monk, his reasons for turning to medicine as a career and much more. The following is an excerpt from that four-hour interview.
As the son of a Buddhist head priest, did you have any reservations about following your family's profession?
Most children born in temples don't want to become monks. It's just a matter of how far away you can get from the gravity (of the family tradition). Some struggle in other parts of society and return to the religious community. But as far as I know, only a handful actively set out to inherit a priesthood.
So you think that people generally become monks because they regard it as their fate?
Yes. Most of them come to terms with that reality. . . . I don't think it's so bad to explore many opportunities outside temples and then, accepting your fate, to return to life at the temple. Even if they were pulled back by gravity, they've still had a good life experience outside.
What was it like for you?
I was also pulled back (laughs). I have one foot in the religious field, the other in medicine. I'm happy with the way it is.
You studied philosophy at Kyoto University. What was it like there?
I majored in religious studies there in the department of philosophy. I studied a variety of things — Western philosophy, Chinese classical philosophy and Indian philosophy. That was in my late teens and early 20s, so my interests were diverse.
What did you focus on in particular?
I was interested in views of life and death, and especially in new religions. I did some fieldwork as I thought the best way to learn about them was to go and feel the live energy of those groups. One that I visited had elements of shamanism and another promoted the idea that the world is coming to an end but God will save us. They had grand, mythical views of the world. I found them appealing, and realized that such views could be easily aligned with political energy — almost like the energy Hitler used to have with his unique view of the world. In wartime Japan, we had a religious group called Omoto-kyo with a unique view and set of values, but it was disbanded in a government crackdown.
Yes. It was founded by a man named Onisaburo Deguchi, who people referred to as Wanisaburo Deguchi. He probably had supernatural powers from the time he was little. One of his followers was a man named Wasaburo Asano, an English literature scholar who was influenced by British spiritualism that had come to Japan in the Meiji Era (1868-1912), and he mixed that with the Shinto preached by Deguchi. Asano contributed to the birth of many other "new religion" groups in Japan.
After graduating from university, you went into Zen training at Tenryuji Temple in Kyoto. I understand the monks' morning training starts at 4 a.m. Is that correct?
It depends. On some days, I used to get up at 3:30, and at 4:30 on other days. About three days a month, when we finished a weeklong ceremony, I was given a break and would be able to sleep until 6.
When did you normally go to bed?
We would finish training under the supervision of a training monk at around 10:30 p.m. Then it was time for everyone to go outside individually, taking a zabuton (floor cushion) with them, and find their own favorite place to meditate. I was expected to meditate for at least an hour, but some motivated ones would continue for two hours. When I was in a good condition, I would continue sitting outside until 4 a.m. when the temple bell rang and it was time to start the morning session all over again.
Isn't it hard to live like that all year round with hardly any time to sleep?
Sometimes you are sleeping while meditating — and that is a pleasure. You might not be sleeping continuously, but you sleep here and there. When you meditate, you sit in the same place for four or five hours, so you can't maintain your concentration the whole time. After a small doze, you are refreshed and gain the energy to concentrate again.
After that, at the age of 38, you were appointed as a superintendent priest of the Buttsuji group, one of 14 subgroups of the Rinzai School of Buddhism, and were thus invited to be based in the group's head temple in Hiroshima Prefecture. What was life there like?
The experience changes depending on where you go. My temple was in the countryside, but even within that small organization there were factions and there was political infighting. To some people I was welcome, but to others I wasn't.
Were you elected to be a superintendent priest?
No. People from the temple invited me to head the temple. However, the fundamental problem with the temple was that it was in the countryside and people were narrow-minded. So they were wary of accepting an outsider, even though they knew they had to change the temple and hadn't the knowhow to do it.
What was it they had to change?
Fundamentally, religion is not suited to organization. When you look at the origin of religion, you see that Buddha and Jesus Christ were individuals, around whom groups of followers were created.
When religious groups are formed, a range of secular principles are also born. That's because the groups have a need to maintain themselves, as well as to expand and propagate their ideas. Then money becomes an issue and groups develop political feuds with other religious groups. Under such circumstances, pure religious beliefs often run counter to organizational needs.
As a result, monks end up discussing budgets, the amount of donations they need to collect and how to achieve their targets by doing this and that. . . . It's almost like a business.
Another thing is, religion does not change. Sutras from 2,000 years ago are often used as the basis of values or how to behave, and monks try hard to put a contemporary spin on them to make them relevant to today's society. But even if you tweak the sutras to fit modern needs, there is a limit. Sutras weren't written with concepts such as brain death and organ transplants in mind. However, monks today are also affected by the scientific pragmatism of the 21st century, so it is extremely difficult to mix those (contemporary) views with the traditional mind sets of their religious groups.
Shortly after you entered medical school in 2000, determined to become a doctor, you were effectively forced to resign from the Buttsuji Temple and lost your official status as a monk. Why did you feel you had to do that, when pursuing a religious calling alone could have been worthy and challenging course?
There are two reasons. Buddhist priests are often criticized for showing only up at funerals and not responding to social needs, and they are all very well aware of the criticisms, but don't know what to do. So it has been a big theme for Buddhism how to help people through the process of sho ro byo shi (being born, aging, becoming ill and dying). But when they wear their robes, people look at them as something ominous. Monks are not even welcome in hospitals. But sho ro byo shi are most often happening in hospitals — with many people dying there. The essence of sho ro byo shi is concentrated at hospitals, yet we can't even freely go in.
What do you mean that you can't go in?
In the West, Christian ministers and sisters have no problem reaching patients inside hospitals. It's the same for some Christian hospitals in Japan. But in Buddhism, because you have to renounce the world to become a monk, monks have been somewhat insulated from the rest of society.
Of course, if you look back in history, there are many priests who went out and helped the public. But under the Tokugawa Shognate (1603-1867), the danka parishioner system started, whereby people were made to belong to temples to prevent them from converting to Christianity. Once a family became a danka member of a temple, their descendants belonged to the same temple semi-permanently, assuring temples their sources of income without having to aggressively look for them. So temples got lazy. The danka system is one reason why Buddhism became corrupt in this country, I think.
Also, the Buddhist robe has come to be associated with death. When I go to a hospital wearing a robe, people look at me coldly. We are never welcomed, and people even ask us, "Has somebody died?" If we tell them that we are trying to console the sick or pass on the teachings of Buddha, we may well be told that we are completely out of place.
So I thought, "Well, then, why don't I go in there wearing a white robe, as a doctor?" That was one, simplistic line of thinking behind it.
There was another reason for me to seek medicine as my profession, and that was that monks look at people's souls and minds, whereas doctors look at people's bodies. I think human beings are made up of both body and soul. So if you want to look at someone holistically, you need to be able to look at both. Monks don't know how to look at humans physically, regarding it as something only material. But when people feel pain, it's because they are damaged physically. You need to know how to look at the physical side of humans, or you cannot talk about life and death. I'm not saying every monk should become a doctor . . . and of course that's just not possible. But a few of us could, and should.
My other reason for turning to medicine was personal, and that had to do with my own father's death, which turned my idea of death upside down. Before that, I was unnecessarily afraid of death and regarded it as something to shun. But I realized that death is a process, and that it affects not only the dying person but also his or her family and others. I saw it for what it is, and that impacted me very much.