Dr Atul Dhingra

Dr Madhur Verma

Dr Sanjay Kalra

English

Indian Journal Of Clinical Practice

GUEST EDITORIAL6 Indian Journal of Clinical Practice, Vol. 35, No. 4, September 2024self‑control (dama), giving (daana), and compassion (daya) (V. 2:1‑3).This, in essence, is the noesis of person‑centered care. From the Upanishads, we learn the importance of being person‑centered1. This inspiration, reinforced in the Charaka Samhita2, and the Thirukkural3, is the foundation of good clinical care. Each person seeking medical care may have a different understanding of what we counsel or explain. We should be accepting of each other’s point of view; and be able to relate to our patients in a personalized manner. These verses serve as an inspiration to respect our patients, and their attitudes, preferences, and values, as we care for them. It is important, at the same time, not to forget our responsibility towards them. Responsible person‑centered care calls for taking “on the responsibility of ensuring that the person with diabetes is offered all relevant information, in an understandable manner, so that he or she can take part in a shared decision-making process, which offers the potential for achieving optimal therapeutic outcomes, without ignoring his or her biopsychosocial context”4.This is highlighted in the Upanishads as well.“The good is one thing and the pleasant another. These two, having different ends, bind a man. It is well with him who chooses the good. He who chooses the pleasant misses the true end.”—Katha Upanishad II:1.We should be able to explain our suggested diagnostic and therapeutic options to our patients, in a simple, easy to understand manner. We also need to work on our trustworthiness and perception management, as “If someone among human beings is healthy, prosperous, a lord over others, fully endowed with all human enjoyments, that is the highest joy of human beings.”—Brihadaranyaka Upanishad IV. 3:33.Our aim, as physicians, is to improve the health, and joyfulness, of our citizens. To achieve this, we need to be person‑centered.“Two companion birds sit together in the shelter of the same pippala tree. One of them is relishing the taste of the tree’s berries, while the other refrains from eating and instead watches over His friend.” —Śvetāśvatara Upaniṣad 4.6; Mundaka Upanishad III 1:1.This verse, found twice in the Upanishads1, underscores the importance of individuality. As physicians, we must understand that each person presenting to us, for care and comfort, has different requirements. Each person responds differently to suggested therapy as well.The Brihadaranyaka Upanishad relates the story of Prajapati and his descendants, the Gods, human beings, and demons. All three came to him, requesting “Father, teach us”. He spoke the same syllable, “da”, to all, and asked if they had understood. All three replied in the affirmative. The Gods said, be “self-controlled”(damyata), the humans said, “Give” (daana), and the demons learnt “Be compassionate” (dayadhvam). To all, Prajapati said, “Om, you understood”.The same syllable, this means, has three meanings, all of which are correct, based upon the context of the person hearing it. The Upanishad summarizes this anecdote, advising its readers to “practice this set of three, Person-Centered Care: Inspiration from the UpanishadsDr Sanjay KalraDept. of Endocrinology, Bharti Hospital, Karnal, Haryana, India; University Center for Research & Development, Chandigarh University, Mohali, Punjab, IndiaDr Madhur VermaDept. of Community/Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, IndiaDr Atul DhingraDept. of Endocrinology, Dr SS Tantia Medical College Hospital & Research Centre, Sri Ganganagar, Rajasthan, IndiaGUEST EDITORIAL7Indian Journal of Clinical Practice, Vol. 35, No. 4, September 2024■ ■ ■ ■our profession navigates the challenges of working in the modern world. We may take consolation from the fact that such concerns are not new.“With juggleries of the non-self-doctrine, with false examples and causes,Going astray, the world does not know, the difference between knowledge ignorance.”—Maitri Upanishad VII:8.“Abiding in the midst of ignorance, thinking themselves wise and learned, fools go aimlessly hither and thither, like blind led by the blind.”—Katha Upanishad II:5.The way forward is also taught by the Upanishads. We need good preceptors, and we need to be good pupils, too.“When taught by a man of inferior understanding, this Atman cannot be truly known, even though frequently thought upon. There is no way (to know it) unless it is taught by another (an illumined teacher), for it is subtler than the subtle and beyond argument.”—Katha Upanishad II:8.“Seize as your bow the great weapon of the Upanishad, and set in it an arrow sharpened by contemplation.Draw it with a mind that has attained the nature of that. The target is the imperishable: pierce that.”—Mundaka Upanishad II. 2:3.REFERENCES1. Roebuck VJ. The Upanishads. New Delhi: Penguin Brothers; 2000.2. Kalra S, Magon N, Malik S. Patient‑centered care and therapeutic patient education: Vedic inspiration. J Midlife Health. 2012;3(2):59‑60.3. Kalra S. The history of person‑centred medicine: a South Asian perspective. IJPCM. 2022;12(1):41‑6.4. Kalra S, Baruah MP, Unnikrishnan AG. Responsible patient‑centered care. Indian J Endocrinol Metab. 2017;21(3):365‑6.

Person-Centered Care: Inspiration from the Upanishads

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Person-Centered Care: Inspiration from the Upanishads

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