When you come to see an Ayurvedic Physician, we are receiving you wholeheartedly. From there, as you sit down for your consultation, we are playing detective and looking at your past, present, and future simultaneously. When we think of the past, we consider what was it on a particular timeline that added up moment to moment with a certain moment that brought you to the present moment with whatever you are presenting with that may or may not have a certain gravity that has taken hold of your state of reality that requires attention, either being the best or not best. The observation and assessment do not stop there, though. What has brought you to the present moment, from your past, will also have weight on your future. What we do together today will in some ways change your past but also alter your future as we make efforts to thwart the trajectory you were heading on if you are suffering or struggling with health challenges, or what we do in the present moment will fortify where you are heading with regards to maintaining and stabilizing your optimal health. All of this is done through the lens of Ayurveda.
More about the past: according to Ayurveda, Diet (Ahar) and Lifestyle (Vihar) are essential components to maintaining health or creating pathologies. Diet is that food, and nourishment, that satisfies the cellular and structural integrity of the body (deha) and mind (manas.) Lifestyle, though not excluded from this list, includes activities of daily routines ranging from eating times, sleeping times, exercise times, working times, creativity times, and even sexual activities. These influences are daily evolving as we move through time and space in this body, as we gain age and wisdom. These same influences are the daily and seasonal practices that are influencing and influenced by the doshas of Vata, Pitta, and Kapha. Vata, Pitta, and Kapha are made of five elements (panchamahabhutas) that make up all of creating to some capacity, proportion, and ratio. Vata, Pitta, Kapha are not to be confused with the idea of being an identity association. Rather, they are to be absolutely understood as being the forces of life, potential, and optimal wellness. Similarly, and conversely, when the doshas are not maintained in svastha (proper health) they become the forces of decay, destruction, and death. Death is a part of life, this is for certain, and within the study of Ayurvedic medicine, Ayurveda being translated into the “science (veda) of life (Ayu)” death is naturally to be comprehended as a part of this process and scientific examination.
When you meet with an Ayurvedic Physician, we observe the hetus (causative factors) that include ahar and vihar, internal (nigantuja), and external (agantuja) influences on your health or ill health. These can make the past up until the present because there may be tendencies repeating themselves that have created the foundation to form and foster the current state of health. These are some considerations with regard to past and present. From here, and using Yukti (logic/analysis) and buddhi (intelligence) with reflection on the materia medica of Ayurveda (samhitas) we draw up in our minds a great deal of information to understand the hetu bal (strength of the etiological factors) and where it/they are headed. This is how Ayurveda can be understood as being a predictive science. We use the siddhanta (essential teachings of Ayurveda) to understand karana karya (cause, effect.) We can understand the great potential that exists and from many to endless possibilities to where the doshas can continue to vitiate and cause havoc, thereby allowing us to gather information as to the momentum of now to where this could lead.
Therefore, when working with an Ayurvedic clinician, we are looking at all three, past, present, and future all right now. It is our intention to be of support in slowing down or even stopping the trajectory of this process by implementing tools such as dinacarya (daily practices), rtucharya (seasonal practices), karmas (physical treatments), aushudha (medicine), shamana cikitsa (palliative treatment), shodhana cikitsa (purification treatment.) We want to support your right to health (svastha) or as being as close to it as possible given the current circumstances and state of reality. By doing much of this, we can deter a certain amount, whether optimal or favorable but not 100%, of what the future can hold with health and ill health.
When we begin you on a protocol, depending upon various factors such as the severity of the condition, acuteness, chronic patterns, or even with minimal issues, we are beginning an unraveling process that sets the “ball in motion” which will allow for a layer by layer reconfiguration of things. This is something that definitely happens over time. Sometimes, oftentimes, when some patients come in and start feeling relief within an immediate amount of time we don’t stop there but take that as an indication that we are going in a positive direction, known as upashay (remediation). However, even if some changes seem to exhibit an opposite effect, this still provides to the clinician as we determine from this outcome that this is not the road to take with regard to treatment as a reassessment is done to steer the path elsewhere; this opposite or “negative” effect is known as anupashay and by this, we clinicians consider this useful information in drawing up another protocol with the opposite qualities (gunas and karmas) to get closer to the bullseye. Often, the “right medicine” is chosen and provides fundamental results; but sometimes some medicines have a cumulative effect and may not be noticeable in the immediate moment but is synergistic with time and are noticed at some point. Of course, as previously mentioned, those instances where we don’t get the desired results can fall under the category of anupashay, and from here we are redirected through yukti on how to proceed and gain upashay. Hence, we never look at the bumps in the road or hiccups as bad things but as an opportunity to reframe what we are doing.
Importantly, it is essential to remember that not all systems of medicine are 100% perfect and that each system has advantages and disadvantages but if there was a system that was as close to 100% that would be Ayurveda. When some people say that we weren’t born with a rule book of life, Ayurvedic Physicians would say that Ayurveda is as close to that as much as possible. It covers from beginning to end, and everything in between; from the first breath to the last breath, even before birth, and after death. Ayurveda is not a mystical science as commonly misunderstood by Westerners, but it is a science that has had extensive research and documentation to support its principles.
As an Ayurvedic Physician, we desire nothing but the best for you and hold the intention and dedication to supporting you in remaining or regaining health. But, it is not for us to want you to be healthy more than you would want for yourself. Financial considerations are important when working with an Ayurvedic Physician because it will take this to be in the game for the long run. To give you perspective, we clinicians feel that there is no price we can put on health and that health is wealth, therefore, maintaining optimal health support the long game of being alive and still having a body that will be the vehicle to take you on this journey until the end. Ayurveda is known as the “science of life and the science of longevity” so it can best create the foundation for this. We also take into account, based on the current Western model of health care, that once you start on the trajectory of medications they only increase with time and age. Allopathy isn’t designed to take you off medications, though many Western doctors wish they could. According to current data, Iatrogenics is the third leading cause of death, after heart disease and cancer, per John Hopkins University research. Iatrogenic/Iatrogenesis is defined as an illness that is a result of medical mismanagement, misdiagnosis, and mistreatment/intervention. Ayurveda does not have such a category of disease per its 7,000+ years of practice. What you pay for now in creating the foundation for Ayurvedic management can only help not only now, but later, if it’s possible. That being said, what are you willing to pay for now versus later? How are you willing to pay? What is the payoff? Fees can get very high when it comes to Allopathic medicine between co-pays, out-of-pocket expenses for procedures and labs, time, appointments, and the overall stress it can put you under in the long run with all the above. Are you willing to pay with your life? Ayurveda can give more of your life back to you, with the right commitment of time, resources, dedication, and investment. Everyone is doing their best, for certain, but there is always room for a little more. Aren’t you worth it? If you have a family, how will they benefit from your well-being? How about your place of employment, means of employment, will they also benefit from your well-being? Creativity comes naturally when the body and mind are capable when they are supported in health. You don’t have to “work so hard” when “the juices are flowing” from an internal spring that is being nurtured properly.
There will always be things that have to be adjusted per season, and at least a year cycle to establish proper patterns to help with the reprogramming/realigning process to health. When we begin our work together today, we are noting in our minds what the long-lasting effects will be as well, in favor of or against health and health practices. This applies to any age that we work with, as Ayurveda covers the entire lifespan of an individual.
A favorite quote that describes the scope of Ayurveda is from Caraka Sutrasthana 1/41: “hitāhitaṁ sukhaṁ duḥkhamāyustasya hitāhitam| mānaṁ ca tacca yatrōktamāyurvēdaḥ sa ucyatē.” This translates to "Ayurveda is that which deals with good, bad, blissful and sorrowful life, and with what is wholesome and unwholesome for it, longevity, and about what Ayu (life) is in itself." (per online Caraka Samhita)
In getting a glimpse inside the mind of an Ayurvedic Physician, we are hopeful that you continue the process, working layer by layer as we aid in the excavation project, layer-by-layer aspects of your health to direct it in a better direction. Don’t jump off the bandwagon yet if you think you’ve arrived at the best state. Just because some major symptoms may have calmed down, appearing gone, doesn’t mean they are. As clinicians, we do not restrict our viewpoint to symptoms. Rather, we use the symptoms as a guide in executing a protocol based on extensive memorized scientifically proven research which not only addresses the symptoms but focused on the root causative factors. Sometimes it’s straightforward, the more simple and short term it is. Other times, we may go round about ways to get there, and sometimes that doesn’t make sense to non-clinicians but there is reasoning conducted in order to ensure the possibility of a successful outcome. Addressing the symptoms is sometimes like a forest fire: we make all efforts to put out the fire (address major symptoms/disease processes), but the forest itself (the body/tissues/organs) has been damaged/charred (depleted, weakened, some cases destroyed), then the recovery of the soil has to begin, partly by time itself but also with concerted efforts in re-establishing the ecosystem (by providing care to what has been affected and rebuild it from there as much and as strong as possible.) Just putting out the fire is not enough. Sometimes it’s not “just acne” “back pain” or “constipation.” These may be symptoms of much bigger ailments brewing. Therefore stopping vanquishing acne is just the beginning. When you stop along the way you are sabotaging the process and can compromise your health issues either in the immediate or in the long term. Ayurveda is not a spot treatment and oftentimes required Kala, which is time, is an essential medicine that can not be emphasized enough. In many cases, it took time to create the current condition(s), therefore, will take time to undo the condition(s), and to some degree depending upon how layered things are and the length of time the condition(s) have existed. There is no quick fix or magic pill! It’s never just any one thing that creates good health or ill health, as it is an accumulation of all the right circumstances that can be causative factors for either.
We are required to do a more thorough job to ensure that whatever path was taken that directed the pathology to where it was in the present moment is not repeated again in the future; this could especially come back with a vengeance and require a stronger intervention to resolve, but as time progress some conditions that may be able to be resolved now may not be years from now. This is one of the reasons why as clinicians we are also postulating and reflecting on the future with how something may evolve. The ball has started rolling and to stop it, in some cases, is usually contraindicated and can cause grave issues. This is usually communicated. Similar to Allopathy (western medicine), we concur with the acronym AMA (Against Medical Advice.) It is safe to say when we suggest to you that we are making progress and at the next level. It is mainly for us to know this, and it is at this stage we may indicate a need to see you less and specify what that will look like. Each case is based on a case-by-case basis. In some cases, stopping may have to occur due to certain reasons such as finances, time, and practicality as time is changing circumstances but it is still essential to transition out of the protocol process as safely as possible. Prematurely ending a protocol process otherwise can cause more harm, and more work to be done should you decide to return, and we try to salvage what is available.
This lovely quote from Caraka states one of the intentions of Ayurveda so simply (Ca SU 30/26): “prayōjanaṁ cāsya svasthasya svāsthyarakṣaṇamāturasya vikārapraśamanaṁ ca|” Which translates to Ayurveda’s purpose is to preserve the health of the healthy and cure the disease(s) of the unhealthy/sick. Additionally, with this being a primary goal, it holds the foundation for life goals as a whole which involves supporting a person’s duty/purpose they are inherently born with (dharma), which creates an attraction for material gain as a result of such efforts (artha), where in doing so there is joy and enjoyment (kama), which inevitably leads towards liberation and sense of freedom of and from the life (moksha.) This is from Caraka Sutrasthana 1/15 “dharmārthakāmamōkṣāṇāmārōgyaṁ mūlamuttamam.” This in Ayurveda is considered “Sreyaso Jivatasyo”, which means this offering and presence of Ayurveda creates the best possible life.
A further point we consider is that there is an "evolution in reverse” process that occurs as a disease process/pathology gains momentum and when you meet with an Ayurvedic Physician we make efforts to halt this and support you in returning back to a state of health and homeostasis (svatha) and that this entire process itself helps to provide insight to you as the patient that allows you to see the elements which contributed to bringing you to a state of ill health. Once you see this as a reflection, you can see, moving forward, what it takes to head in the same direction and you can make better choices to avoid such things. This is an ideal scenario we hope for, as clinicians.
We are also generally preparing how to address certain issues that may arise along the way; a phase-by-phase protocol is generally outlined and the present moment will dictate how to navigate more precisely. We have to be prepared, as best as possible, for any given moment, while being humbled by the experience as part of our ever-ongoing journey in life as a Vaidya (Ayurvedic Physician.)
With regard to our thoughts on Panchakarma (PK), we understand as physicians of Ayurveda that not everyone is Adhikar or “fit” for this elaborate, extensive, and very involving process. PK is generally for those who are between the ages of 12 and 70 and requires time, resources such as financial and local support staff, commitment, focus, and diligence, along with patience. Due to the fact that this is not readily practical or available for many, we (clinicians) resort to palliative care that occurs over the long term and is not as aggressive or as intene as what PK offers. Both have their benefits.
Being an Ayurvedic Doctor also means we are to hold ourselves accountable as much as possible while knowing that we are still human and each has our own parts to play and personal experiences with life to contend with, we are to live as closely to the teachings, around as much as we instruct others to do so. Good health and vitality, are essential to the foundation of our practice so that we can emanate the energetic capacity that gets emitted as we touch others through our words, physical touch, and presence. The teachings we convey to others we are to integrate as much as we can within the context of our own lives so that we have the shakti (energetic current), and adequate prana (life force) as part of the medicine. This enables us to have a larger bandwidth than the average, and permits us to continue life for decades in order to fulfill our dharma (life purpose) in providing these teachings to others so that we can continue to pay it forward to one another as much as possible; leaving a wonderful imprint on the planet as a whole. This system of medicine is not about not living in integrity with it. It is our duty to do our due diligence and continue to study, observe, learn, practice, share, and repeat. We are holding the space for a lot, often simultaneously; sometimes there are some things that are unseen but that does not mean they are not there, or happening. These inner workings are in the background. We may have a lot on our minds, but many of us are guided by the passion for these teachings and the innermost place of our hearts. Becoming an Ayurvedic Doctor is no easy task, as it shouldn’t be, and the honor of this calling is not for everyone to follow. Few are chosen for this process and it is no light-hearted task but certainly a joy. It takes a certain kind of person, and what we also learn in the samhitas, as a certain karma to lead us on this path to this study. This study is a lifelong process that doesn’t stop in the gurukula (school/classroom); in fact, life itself is the guru and is the primary classroom for all of this.
Life is ever dynamic and it is our responsibility to continue to study the samhitas (classical texts) and integrate the teachings, as well as apply them to present-day circumstances, as this continued to promote the essential siddhanta (teaching principles) that Ayurveda is anadi, timeless and eternal. Ayurveda is ever-expanding while resting on the digestion of the primary principles that were shared by the earlier scientists of Ayurveda such as Caraka, Sushruta, and Vagbhata.
So, if you’re wondering how this health tidbit of this month, which relates to the topic of having a “Glimpse Inside the Mind of an Ayurvedic Physician,” fits into the intended purpose of what to take away from this article that you can apply to your own mind and life it is about trusting the process, conveying when there is ambiguity or lack of clarity, partly surrendering, and accepting the unfolding experience that you are signing up for in the name of health, holistically! Holistically is the whole picture. Ayurveda is the whole picture beyond any other system and has an extensive medical library of scientifically tested and proven knowledge. Proceeding in life with Ayurveda will prove to be amazing. Though, Ayurveda is for everyone as it is a universal system but not everyone is ready or fit for it to be invested in the long term. The investment you make, however large or small, will show over time. It’s like choosing to put a dollar a day in the bank or five dollars a day, and seeing what interest has accrued in your favor. This depends on your commitment, resources, and dedication. It’s definitely worth it, in my humble opinion. It may not be easy, as we (clinicians and patients alike) wish it was or that it could be. In the instances that it may not seem easy, that can be part of the healing journey in and of itself. From the perspective of an Ayurvedic Physician, there’s a “method to the madness” and this can be usually considered as part of the grace of the overall human experience, journey, and karma. The process is not usually a straight line, and in some cases the line takes many different directions from down (adho), to up (urdva), to side-to-side/laterally (tiryak.) Ayurveda is universal, it is for everyone, but not everyone is for Ayurveda. Ayurveda is ready for you, but are you ready for it? Come find out and join the journey to better health. All you need is time, dedication, commitment, resources, and to do your best!
Ayurveda was in the past, it is still present, and will certainly be in the future!
Namaste,
Dr. Antonio Aragona AD, Traditional Ayurvedic Physician
DISCLAIMER: This information is meant for educational purposes only and is not considered medical advice. Any changes in lifestyle should be reviewed by a qualified practitioner and/or primary care physician if you are currently under their care for specific conditions.
