( By Dr Ramesh Kapadia )

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Coronary Heart Disease

Coronary heart disease is the single greatest cause of death in the Western world. Its incidence even in the developing countries is growing at an alarming rate. This incidence is attributed to the secondary habits, rich fatty diet, high blood pressure, diabetes, smoking, alchol and increased serum cholesterol. It has, however, been observed that in more 50% of the patients of coronary heart disease, the said oft-repeated factors do not operate. Something else is happening in these individuals, who prematurely become the victims of coronary heart disease without any of the known risk factors. ON the other hand, it is observed that the mere control of risk factors does not always affect the onward march of the progress of coronary heart disease. The recent experiment of Dr. Dean Ornish clearly shows that when the risk factors are controlled alongwith the indepth stress management by the progressive deep relaxation, meditation, visualization, group discussion and the sharing of feelings, the results are amazing. An all-out comprehensive program has, therefore, been indicated to forestall the ravages of the diseases.

One special feature that characterises a human being as distinguished from other animals in the world is that we possess the faculty of self-awareness. This is an attribute which is peculiar to our being human. A plant has life ; an animal has also life plus consciousness. But the human beings have consciousness plus self-awareness. We are capable of being aware of our own thoughts and capable of focussing our awareness on anything that we may wish. Most of the time our awareness remains focussed on all the affairs of our mind related to our individual self. The moment our awareness is brought to the element, which is present in all of us and in all the manifestations of the universe also, boundless in space and time, the healing starts. The crucial point is how to bring our awareness to this eternal reality. The simplest method of achieving this great objective is meditation.

It seems to me that the most important part of this program is the technique of shavasana and meditation. The technique is simple and yet quite effective. The relaxation that is experienced by the participants is unique in the sense that they feel totally relaxed both in their mind and body. All the same, it is felt that there is something more than mere relaxation that is experienced by the individual who meditates. As emphasised time and again, our greatest limitation comes from our perception that we are individuals limited in space and time. David Bohm, the physicist of repute, observes that this feeling of separate indentity as an individual is not separate whatsoever in the various observations made by the modern physics. Similarly, our concept of time as a fleeting component having past, present and future is not supported by any experimental observations of modern physics, which considered time and space as a single entity. The concept of time as divided into past, present and future is purely for the convenience of our physical existence. When a patient of high blood pressure, during biofeedback therapy imagined that he was sitting on a lake of time instead of a river of time, his blood pressure got lowered. Most of the stress-related diseases are attributed to the factors of time - urgency. During meditation, when a person assumes a comfortable posture either sitting or lying down and closes his eyes and brings his awareness to the process of breathing, he becomes one with his breathe and experiences a feeling of connectedness with the whole universe. Again, there is an experience of the eternal present. This experience conforms with the ultimate reality which is enunciated not only by Vedas and scriptures but also by modern physics. That probably is the cause of total feeling that follows the practice of meditation. The lifestyle changes and one turns into a strict vegetarian and a teetotaler. He is motivated by the experience of reality that happens during meditation. Dr. Dean Ornish observes that practice of meditation helps the participants of his program to change their life style which would have otherwise been quite a formidable thing to do for an American. Moreover, becoming a vegetarian andgiving up tobacco and alcohol improved the quality of meditation. Such indeed, is the happy cycle of events. This feeling of oneness with the universe and the experience of the eternal present also give rise to certain behavioral changes in the meditator which are altruistic in character. There is also a change in the perception of the meditator about the various events occuring in his life, both happy and unhappy. Fear and anxiety are replaced by sense of security and sense of confidence. So , there is a grand all-round benefit due to the practice of meditation as taught in this program. While writing this we have one full year’s experience with about 200 participants and the feedback from majority of the participants is that the benefit derived by them by attending this program is instantaneous. The patients who have severe coronary disease admit of benefit which is even quicker than that of the patient who have got mild coronary disease. Such an enormous benefit to a person is a highly prized experience besides its salutary effect on the treatment of the disease. This program has a potential to heal the society as a whole, and,therefore, we thought of naming this activity as " Universal Healing ". The title of this book Primer of Universal Healing also conveys mostly the same picture that emerges from a simple technique very easy to perform. It has a great potential of making the common man aware of his real identity and thus effecting healing.

The group discussion and the sharing of feeling , which is a part of the program also becomes very effective when it is preceded by the practice of meditation. The participants feel very much connected with one another and they frankly give vent to their feelings which are shared by the entire group. The various problems that are discussed in group meetings need not all have solutions. The mere discussion and sharing of feeling in that atmosphere takes away the burden of the problems. The practice of shavasana before meditation prepares the individual for meditation. Shavasana, as we know , stems from the progressive deep relaxation. It is achieved by prior stretching and relaxation of the group of muscles one by one as shown by the various stretching and relaxation exercises. As the father of medicine ( Hippocrates ) has observed, the mind is present in all the cells of the body and so when the body is relaxed during shavasana, the mind too automatically relaxes.

For a long time I have been pondering over the complex problem of coronary heart disease. Frankly speaking ,what we know about the disease seems to be a tip ofthe proverbial iceberg. Indeed, much remains to be elucidated. However, I have felt all along during the course of my experience over 30 years in dealing with the patients of heart attack that panic kills more people than the actual extent of heart disease. It is well known that sudden curtailment of blood supply to the part of heart muscles results in heart attack. Experience has revealed that more often than not the approaches in dealing with the problem probably end up in adding to the patient’s panic, notwithstanding the anxiety of the medical personnel todo their very best for the victims in desperate need of help. Theoretically, if one were to open the heart, find out the blockage in the artery and remove the blockage by surgical procedure, the object of restoring the blood supply would be achieved. But how can this be done without causing considerable trauma to the victim,since the surgical process inevitably brings about an increased demand for oxigenated blood by the heart muscle, thereby actually resulting in the extension of damage to the heart muscle, and thus aggravating an already critical situation. The only logical and reasonable step which is applicable to a large majority of patients of acute heart attack is to reduce the demand for oxygenated blood by the heart muscle by sedating the victim and using drugs wherever feasible with a view to dissolving the thrombus in the coronary artery and relieving associated spasm by using a drug which dilates the coronary artery. In most of the cases, a sublingual glyceryl trinitrite and a tablet of disprin will suffice at the initial stage. However, the most important issue, it seems to me is to reassure the patient and his immediate relatives that eventually all will be well. This extremely important aspect of reassurance is neglected because of excessive dependence on hitech measures and the diminishing doctor-patient relationship in the wake of medico-legal implications of modern medical practice. The importance of self-confidence on the part ofthe attending physician,his ability to reassure the patient and his relatives in the face of such an ailment , widely dreaded by the public cannot be easily exaggerated. It is this ability on the part of a physician which contributes a great deal in bringing about a favourable outcome in most of the cases.

After recovering from heart attack, the rehabilitation of a patient is of crucial importance. Here again, a routine approach of ascertaining the exact extent of coronary heart disease and dealing with it by angioplasty and bypass surgery has not made an appreciable difference in reducing either mortality or morbidity of this disease. A simple cost-effective approach is very much needed for a disease of such dimension almost engulfing the entire civilised world. It has been observed that almost fat-free strict vegetarian diet, modest exercise like walking on a level for about 45 minutes every day, the giving up of tobacco and excess of alcohol, control of diabetes and blood pressure whenever present have resulted in some mitigation of the incidence of disease. Various drugs used till today for reduction of increased cholesterol have been invariably accompanied by unacceptable side effects. The program developed by Dr. Dean Ornish throws new light and raises the hope of solving this complex problem of coronary heart disease.

Swami Vivekanand asks the following rhetorical question in his Rajyog and gives its answer :

‘What is the use of such knowledge which is guided by meditation ?’

During meditation, an individual comes face-to-face, as it were, with something which is never destroyed, something which is by its own nature eternally pure and perfect, will no more be miserable, no more unhappy. The individual experiences the eternal presence. Man will find that he never dies and he will have no need to fear it any more. Indeed, when a man realises that he is perfect, he will have no more vain desires.

There will be no more misery, there will be perfect peace even in mundane existence. Just as you would take up any other science exactly in the same manner you should also approach this science for your close study. There is neither misery nor risk in it. It was, therefore, quite gratifying to find that Dr. Dean Ornish, in his program of shavasana and meditation made these remarks of Swami Vivekananda come true. In fact,the technique of shavasana and meditation taught in the program motivated the participants to change their life style. They could do without smoking and alcohol and even enjoyed low-fat strict vegetarian diet. Moreover, their reactions to daily stresses of living also became healthier. The word meditation is derived from the Latin word meditari probably a cognate of ‘mederi’ meaning ‘ to heal’.

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