Tibetan thangka painting of the Medicine Buddha


A Jewel in the Lotus

Buddhist chaplaincy includes compassion and ‘skillful means’.

Medicine Buddha, Bhaisajyaguru (detail), pigments on cloth. Tibet (18th–19th century). Rubin Museum of Art. Gift of Ralph Redford, C2008.19 (HAR 57001)

By Chris Berlin

“If you, monks, do not tend one another, then who is there that will tend you? Whoever, monks, would tend me, he should tend the sick.”
—The Buddha, Mahavagga, Vinaya Pitaka, vol. 4

The Buddha’s status as the “great physician” is well known throughout the Buddhist world. The Four Noble Truths, the foundational teaching upon which the rest of Buddhism stands, follows the logic of the medical model in what ails us most: 1) The malady—“Life is filled with discontentedness and thus we suffer”; 2) The cause—“Desire and craving are the roots of our suffering”; 3) The prognosis—“There is an antidote to this condition in the cessation of clinging and desire”; and 4) The remedy—“The Eightfold Path.” Even prior to the Buddha’s first teaching, his awareness of aging, sickness, and death as inevitable to our human existence was at the heart of his response to human suffering. Here is the pivot where the “Great Physician” then turns toward an anguished humanity as the “Great Provider of Spiritual Care.” Looking deeply into the stories of the Buddha’s life, his teachings, and the practices and traditions that evolved since these beginnings in his ministry, we find that Buddhism is fundamentally a caregiving tradition. These sources have helped me, as an instructor in spiritual counseling and Buddhist ministry at Harvard Divinity School, to shape a unique framework for ministerial training and spiritual formation rooted in both the Buddha’s teachings and the traditions and practices that have evolved since. And consistent with the experiential insights the Buddha engendered in his followers, a pedagogy of what Buddhists call “skillful means” invites students to draw on their own experiences for the purpose of ministerial training and spiritual care. This has never been more relevant than during the present time of pandemic.


In June 2007, one year after graduating from HDS with my MDiv degree, I began working as a full-time clinical chaplain at the Dana-Farber Cancer Institute and on the oncology floors of Brigham and Women’s Hospital in Boston. At that time, there was very little training available for a lay Buddhist practitioner to translate a long-term dharma practice into interfaith caregiving and the spiritual “triage” needed in the hospital setting. At the time, HDS offered few courses specific to clinical chaplaincy or end-of-life care; direct training in hospital chaplaincy was largely a function of Clinical Pastoral Education (CPE) outside academia. Nevertheless, Buddhism provided me with a deeply rooted foundation for the interfaith work of professional chaplaincy, a world in which chaplains are tasked with spontaneously dropping into the existential, often theological, crises born of serious illness in cancer patients. Moving about the various infusion floors, oncology clinics, and inpatient units, I reflected at the time how much the Buddha himself encountered pervasive illness and death as a regular part of the society in which he lived and taught during the fourth or fifth century BCE in the regions we now identify as southern Nepal and northern India.

It was helpful to feel this solidarity with the Buddha—almost an accompaniment—in caring for the sick and the dying as a chaplain.

It was helpful to feel this solidarity with the Buddha—almost an accompaniment—in caring for the sick and the dying as a chaplain. What we often refer to in ministry as a “calling” was wholly motivated by the Buddhist dedication to practicing dharma wherever suffering was to be found. It was the central challenge posed by the Buddha himself in attending to the sick and cultivating fearlessness in the midst of death and dying. I experienced this as bringing the fullness of my practice and faith in Buddhism into matters of impermanence and mortality, grieving and loss, as well as of hope and inner healing in the midst of adversity and spiritual crisis.

One patient, Jane,1 a college English teacher with a stage IV lung cancer diagnosis, called herself an “atheist” and often would say she envied those who had a strong faith in God. Jane had a very direct, “no nonsense” disposition and she admitted being seen by her sister, nephews, and nieces as distant and emotionally unavailable. And yet, Jane was terrified. I recall at one point feeling as if the Buddha were sitting beside me as I listened to her express her biggest fear, that of dying in pain. Jane was cautiously curious about Buddhism, occasionally asking for guided breathing meditations to help ease the stress of her fear (and, it seemed to me, to leave behind the skeptic who resisted religion with such effort—even for the odd fifteen minutes). One day, she asked me for a resource that she could listen to during the evening hours at home. I offered her a CD of Buddhist teacher Pema Chödrön’s From Fear to Fearlessness, unsure whether it might help. Two weeks passed, and when I saw Jane again she seemed different somehow. She mentioned listening to the CD every night as she fell asleep and feeling as if her heart was changing. Her sister, who had accompanied Jane, also remarked, “I don’t know what you said to Jane, but our entire family is surprised by how much more loving she is now.” Jane, overhearing this, smiled with a warmth I hadn’t seen in her before. Her understanding of compassion had not only blossomed but was transforming her relationships with her family. She was more loving, more accepting, and more attentive to their needs—in effect, a better listener and more compassionate. She confided in me her feeling of being more at peace and filled with more gratitude for the blessings in her life. Jane died the following month, without pain.

Without expectation or clinging to outcomes, we can help plant the seeds in simple ways to help each other learn more deeply, more fully, about who we truly are.

I couldn’t help but feel as if the Buddha’s wisdom was alive in my experiences with Jane. There is a simple truth in trusting the potential for one’s own deep experiences to transform one’s life and heart in the midst of great adversity. This is one way to define “faith” from a Buddhist perspective, as has been beautifully articulated by Buddhist teacher and author Sharon Salzberg in her book Faith: Trusting Your Own Deepest Experience. And it is at the heart of the Buddha’s teachings that we can inspire each other to do so mindfully and through skillful means. Without expectation or clinging to outcomes, we can help plant the seeds in simple ways to help each other learn more deeply, more fully, about who we truly are.

Chaplaincy has always been at its core a contemplative practice for me, both in the calling itself and in the challenge to respond to death and dying with a skillful balance between vulnerability and fearlessness. Much like Jane discovered, accepting impermanence allows for a recognition of the preciousness of every present moment. And mindfulness of the ubiquity of impermanence can also inspire compassion for all beings; we are all part of the ever-unfolding process of change and transition. This perspective provided by the Buddha is evident in every moment we can watch the vicissitudes of mind and feeling.

We caregivers share in this vulnerability, but over the course of several years, this daily devotion to the contemplative dimension of spiritual care stretched and strengthened my capacity to be resilient from within my Buddhist faith. It also called for a deeper dive into practical applications of the Buddhist teachings in my work with patients and their families and friends. Especially relevant to me at the time were the Great Physician’s teachings around death and dying, uncertainty, fear and groundlessness, and the antidotes to these forms of acute suffering through mindfulness, compassion, and practical approaches of attending to the grieving and the sick, either by teaching or by example. The heart of this for me has been to bring a depth of mindful presence, an open awareness, and a spacious, open heart to all encounters. Whether on the cushion or showing up at the bedside, this suggests a spirit of “suchness,” or an accepting, unfiltered, and direct experience of reality just as it is, without judgment or reactivity—in essence, an even balance of compassion and equanimity.

The opportunities to grow through the offerings provided by Buddhist teachings were also not lost on some patients upon learning of my background. Referrals would often come to me through nurses, medical providers, or social workers recommending patients reach out to me, often for help in learning mindfulness or stress reduction methods. Increasingly, I was asked to lead weekly mindfulness sessions in the chapel, teach mindfulness workshops, and speak to oncology support groups about stress reduction and mindfulness and to offer classes in these areas to staff in the various Dana-Farber office spaces or clinics in and around the Boston area. People would ask about the Buddhist view on a range of themes, often seeking new insights into their lives or circumstances. The most commonly asked questions would include: What is mindfulness? How does someone practice compassion in the midst of physical illness and fear of the unknown? How does Buddhism speak to the feeling that my illness is a punishment from God? Can meditation heal cancer? Sometimes the urgent, critical question would occasionally pop up, What does Buddhism say about suicide?

Although the latter sometimes required additional intervention by the medical team, responding to these questions meant taking the person’s own context, spiritual orientation, and way of making meaning into account. At the same time, Buddhism provides many tools of cultivation and has a clearly defined approach to practicing mindfulness, namely, by attending more deeply and nonjudgmentally to one’s moment-to-moment experience of one’s breath, body, feeling states, and mental states—bearing close witness not only to those experiences but to their impermanent, changing nature and to the insights one gains by being able to hold it all with an open, gentle awareness. Moreover, the question of bringing compassion to the suffering of illness often begins with extending compassion toward oneself in the midst of how the person relates to pain or discomfort. Most of us feel a profound aversion to experiencing the unpleasantness of illness, and it takes a great amount of mental and emotional energy simply to endure it. Compassion for oneself can help to soften that “efforting” of being ill, so the emotions within the discomfort—that is, the affect that arises from the pain, and about the pain—can become clearer.

In other words, pain is rarely simply pain but has within it many emotions too. Compassion directed at these feelings while practicing mindful breathing can be quite helpful if the discomfort isn’t too severe. And compassion for others is equally important as a fundamental practice for Buddhists to cultivate during challenging times. I found that most people were simply looking for practical solutions to anxiety, discomfort from treatment side effects or pain, or reducing stress before or during chemotherapy treatments—staff, too, would ask for guidance and resources for breathing and meditation exercises. Others sought deeper ways to make meaning of their situation in the absence of a religious orientation or a satisfactory view provided by their own tradition.

The Buddha draws a very practical correlation for us between mental suffering and physical discomfort—what we might call the “mind-body connection” in today’s terms.

It is said that the Buddha once fell seriously ill when he was in his 80s and himself practiced mindfulness in the midst of his physical pain and discomfort, thus easing his symptoms and quickly dispelling the illness. When asked about this by his concerned cousin and closest disciple, Ananda, the Buddha explained to him the benefits of cultivating deep physical ease in the midst of illness by relinquishing both discontent and desire by sustained concentration on formless awareness. His own testimony here relied upon the integrative power of practicing mindfulness of body, feelings, and mind and cultivating a skillful balance between effortless abiding and being diligently mindful without the two pitfalls of attachment or laxity overwhelming the mind.2 In this account, the Buddha draws a very practical correlation for us between mental suffering and physical discomfort—what we might call the “mind-body connection” in today’s terms. The benefits of mindfulness for cancer patients have been equally evident in similar ways and to varying degrees, depending on each person’s level of discomfort, prior experience with meditation or yoga, medication side effects, and capacity for cultivating calm abiding and clarity of mind on any given day.


Despite this interest among patients and the “ministry of mindfulness” I enjoyed at the time, it was essential for me to remain an “interfaith” chaplain and not proclaim the Buddhist view, opting instead for supporting others within their own systems of meaning, spiritual leanings, or religious traditions. Borrowing from the progenitor of modern psychotherapy, Carl Rogers, clinical chaplaincy must be “person-centered” and patient-driven as we meet people where they are, rather than where we would like them to be. And as “where they are” can change from one day to the next, we remain fluid and agile, moving alongside them mindfully and in a spirit of solidarity and companionship on their path.

At the heart of this approach is what we can call the “jewel in the lotus,” which becomes the source of skillful responding in that what we offer is appropriate for the person in our care. In this often-referenced Buddhist metaphor, the jewel signifies a boundless compassion that is fully responsive to suffering and moves us to alleviate that suffering unconditionally and spontaneously as we encounter it. The lotus represents the pure heart of awakening planted in the mud below the water’s surface. In other words, there exists an opportunity for spiritual growth arising from the challenges of adverse circumstances. We seek to bring this loving heart (the jewel) skillfully into the source of suffering itself in service of the potential for spiritual transformation (the lotus) that “the mud” provides. Implicit here is that discerning wisdom plus competency is the foundation for skillful responding. This means fully meeting others where they are while bearing witness both to the suffering they carry and the potential they hold to grow through their own realizations in their encounters with a chaplain. This is at least what is possible as we invite, or are invited, into the encounter, without expectations or attachments to the outcome.

In Buddhist terms, this discerning response is called upaya—“skillful means” imbued with percipient wisdom to alleviate suffering and, if possible, its roots. This term refers to a capacity we can intentionally cultivate and grow through experiences of attending to others by looking deeply and listening mindfully. And, as a person-centered response, it calls for expedient ways of caring appropriate to those who suffer by accompanying them in their own landscapes and existential leanings. This helps to foster greater empathy in understanding and perhaps leads to insights at a time when someone may be feeling the most alone. This is, of course, not just a Buddhist approach but rather a clinical standard in chaplaincy training overall. For Buddhists, however, responding to suffering in this way must be well rooted in both understanding how the Buddhadharma can support the chaplain’s capacity to be present with suffering and by becoming “self-less,” learning how to skillfully support others within their own context through what in Zen is called “beginner’s mind.”3 This involves a conscious application of mindfulness brought into the relational realm of our work. By attending closely to and looking deeply into our experience of our breathing, body, feelings, and mind while listening to another person, we can gain insights into how we are showing up and whether we are truly present with another’s experience or are seeking to problem-solve it through our own opinions, thoughts, or agendas related to the outcome of the encounter. In this way, we hold an even balance between effortless abiding as a listener and a nonjudgmental attunement to our own experience of the listening and all that we bring into it.

Cultivating mindfulness here is like this: We bear witness to it all, embrace it all, and respond with more cognizance of the feelings we pick up from the other through empathy and by listening more deeply with clear, open awareness.

Cultivating mindfulness here is like this: We bear witness to it all, embrace it all, and respond with more cognizance of the feelings we pick up from the other through empathy and by listening more deeply with clear, open awareness. Relinquishing the commentaries and opinions in our own mind, or the outcomes we associate with our roles as clinical chaplains, we are more free to make a gentle, compassionate heart more authentically available. This is, in essence, what it means to be “self-less,” in that the encounter is less about us, and more about the insights possible for the other person and the shared space we inhabit together in the interest of their well-being. This is also the foundation for a “beginner’s mind,” that is, the attitude of “not-knowing” what’s best for the other person from our own side, but that there is wisdom possible in our interaction and that we can trust this process to reveal that wisdom without our controlling it or constructing a narrative from it through the authorship of our own mind. For this reason, I ask students in certain classes in Buddhist ministry to practice counseling with each other directly after practicing a mindfulness meditation. This helps to put students in touch with a more contemplative approach to their listening and allows them to attune more directly to the unfolding process within and beyond their experience.

Buddhist teachings as we learn them in principle and through study do not always translate easily into practical applications involving real-life matters of life and death. Life does not often fit into the forms we project onto it. This is why Buddhism has always sought to relate its teachings to the real-life experiences of human beings—and ministry education must do so, as well. From a pedagogical standpoint, doing this in the classroom provides both a challenge and an opportunity. How does one bring the experiential dimension into the academic setting in a way that both educates and engenders ministerial competency as a spontaneous, lived response to suffering? And the opportunity—the lotus growing from the mud of adversity—is perhaps in the realizations students surface through their own introspective integration of experiences in self-learning and spiritual formation. The theoretical foundations for such ministerial arts as spiritual counseling, assessing care needs, and responding to ethical dilemmas provide the building blocks to do the work. This is a fully dynamic process when it is fostered skillfully and with care. And it can equally impact the instructor and enrich our own understandings in much the same way chaplaincy does. For me, with a strong clinical background and as a lay teacher in the Tibetan Buddhist tradition, finding this balance in the classroom has enhanced my own realizations around clinical skill building and spiritual formation through the Buddhist lens.

One example of this is the course I teach with Cheryl Giles, Compassionate Care of the Dying: Buddhist Trainings and Techniques. The course interweaves teachings in the Buddhist view of impermanence and death with meditation practices, group processing (through what is commonly called “council practice”), and close supervision of students’ well-being to help them metabolize and overcome their initial resistance to being with death and the dying. This is both an essential step in preparing for hospice or hospital settings and an opportunity for spiritual formation. In the first paper assignment, students write their own obituary and process the experience together in a safe space. Here, the opportunity arises for students to view death not just through the lens of fear or unpleasant experiences around death they may have witnessed in the past, but rather to reencounter it with curiosity and a “beginner’s mind,” an attitude of “not-knowing.” By doing so, they are able to attend more deeply to the experiences they are having. And through mindfulness training, the present moment itself opens up into a much more meaningful reality by acknowledging the precious nature of being alive.

Encountering our mortality in a mindful way, we are all able to be more fully present to others who are dying.

At the end of the class, students are tasked with presenting a “Death Box,” their own personal collection of items holding deep significance: books, ritual objects, readings, music, living wills, or other important things they wish to have with them at death. We instructors have done this work, too. Encountering our mortality in a mindful way, we are all able to be more fully present to others who are dying. Healing the rift between the reality of our mortality and our fear and avoidance of it is a core aim of the class. This opens the door to more deeply cultivate empathy, awareness, and a fearless approach to accompanying others at the end of life—what we can call a “lived pedagogy” that invites one to be transformed by the process.

The Buddha was frequently concerned about caring for the sick, attending the terminally ill, and knowing the importance of maintaining a healthy body. Several sources tell of the Buddha’s exhortation to change our view of our own circumstances and cultivate wisdom by perceiving reality in a clearer and more expanded way. Here, in addition to practical insights into caregiving, the Buddha teaches wisdom as an antidote to suffering in much the same way we might heal an illness. We find repeated instances of his teaching the monastic community about how to skillfully care for the sick, the dying, and the grieving throughout the Buddhist canon and other subsequent textual sources. A well-known account is the story of Kisa Gotami and the mustard seed, in which a wealthy woman in a neighboring community is devastated and inconsolable after the death of her son. She has heard of the Buddha’s powers and goes to him, begging for him to restore her son’s life. His reply is to give her the task of collecting a mustard seed from every house in the village that has not known death. She complies but returns empty-handed since all households have experienced the death of a loved one. Realizing the ubiquity of such loss, Kisa Gotami is deeply moved to compassion and is then able to give her son to the charnel ground. She joins the Buddha’s community and becomes a nun for the rest of her days.

In another lesser-known example, the Majjhima Nikaya explains the Buddha’s teaching on the ways to abandon sorrow through wise discernment. These consist of practical guidelines for carefully minding our attention in the midst of suffering so as not to be drawn into pitfalls that can easily overwhelm us when we are most vulnerable. Interestingly, the Buddha explains that not all of these pitfalls are to be embraced or even confronted; some must be endured, others avoided, and still others removed altogether for us to maintain a sense of well-being in the midst of sorrow. In other cases, he advises non-attention to a given pitfall, or the restraint of one’s own tendencies, as well as the cultivation of the seven factors of awakening as laid out in the Satipatthana Sutta, the Buddha’s central teaching on mindfulness. Here again, wise discernment and skillful means are two sides of the same coin and suggest a relational dynamic with ourselves, with our thoughts and tendencies, and with others in our lives.

These two texts are among many that provide distinctly Buddhist approaches to skillful means. In another course, Buddhist Chaplaincy: Spiritual Foundations in Caregiving Practice, I rely on another lesser-known text within the Vinaya Pitaka, the voluminous text on the Buddhist monastic codes. One part of this is called the Mahavagga, which includes a story of the Buddha visiting a monastery and witnessing a monk, acutely ill with dysentery, left unattended by his peers. After cleaning up the monk himself and attending to the man’s needs, the Buddha inquired of the monk and the community how he had come to be in such a neglected state. The Buddha then addressed the monastic community by teaching five qualities of an effective caregiver:

Endowed with five qualities, monks, is one who tends the sick fit to tend the sick: he comes to be competent to provide the medicine; he knows what is beneficial and what is not beneficial; he takes away what is not beneficial, he brings forward what is beneficial; he tends the sick (from) amity of mind, not in the hope of gain; he does not become one who loathes to remove excrement or urine or sweat or vomit; he comes to be competent to gladden . . . to delight the sick from time to time with dhamma-talk. Endowed with these five qualities, monks, is one who tends the sick fit to tend the sick.4

Here, the Buddha provides a five-fold structure to follow in caring for the sick: 1) skillfulness in one’s role relies on competency when applying the remedy; 2) discernment in one’s response includes relinquishing what is unhelpful; 3) one’s motivation is rooted in kindness and selfless compassion; 4) an absence of revulsion in encountering the unpleasant aspects of a sick body; and 5) a joyful willingness to occasionally lift the spirits of the sick person through spiritual conversation and support.5 Each of these qualities can be touchstones for chaplaincy training, intentionally cultivated, and they can serve as points for self-inquiry and spiritual formation in the context of the ministerial arts. Done mindfully in a community of peers within the classroom, such explorations can yield opportunities for a nuanced form of learning that bridges the earliest Buddhist teachings with contemporary settings in hospitals and hospice centers.

A lived pedagogy is thus an experiential one. In chaplaincy, we learn about doing this work by becoming the “instrument” of spiritual caregiving ourselves.

A lived pedagogy is thus an experiential one. In chaplaincy, we learn about doing this work by becoming the “instrument” of spiritual caregiving ourselves. This means nurturing an authenticity in the inquiries we make into ourselves, engaging our capacities and our growing edges. This is then put into dialogue with source material and the theoretical foundations central to the academic study of ministry. Students in field education placements who enroll in ministry courses focusing on Buddhism are encouraged to bring their field experiences into the classroom and explore them through the Buddhist lens. Check-ins at the start of class invite these opportunities, and peer-group processing, contemplative practices, and feedback from the instructor(s) seek to surface a deeper understanding of those experiences. Moreover, the chance for mutual learning can be fruitful here for students not yet participating in field education. Both the wisdom and the challenges presented in class by students in the field are witnessed and reflected upon by the rest.


In the days of March that led up to the “great migration” to online learning due to COVID-19, an increasing sense of anxiety began to take hold as we prepared to teach and learn through Zoom. The final in-person meeting for Compassionate Care of the Dying seemed oddly ordinary, given the circumstances unfolding around us. We meditated on cushions, discussed readings, and contemplated how to apply the Buddhist view of balancing compassion and equanimity to spiritual care. And we instructors checked in with students to process the transition ahead, as well as attending to basic logistical matters related to the class. Perhaps the most noticeable feeling in the air was the uncertainty of what was to come, both societally and individually. Students were also faced with practical concerns around field education placements during lockdown and what spiritual caregiving would now mean for them in these sites.

The task of transitioning to online learning had little to do with adjusting our pedagogy and more to do with preserving the intimacy created by this community of peers, a nonmonastic “sodality” of sorts. This was similarly true for other HDS instructors in ministry courses in which the invitation to explore the intimate terrain of personal faith and service had already been established. Then came the sudden departure of peers, faculty, and staff from all campus spaces. Relegated to our homes for an indefinite period of time, it was easy to feel the abruptness of this separation and, for some, to feel more viscerally the angst of solitude and disconnection. As co-instructors in the course on death and dying, Cheryl and I knew the central task was to preserve the essence of intentional community that defined our class environment, as well as the intimacy it fostered. But how would we do this in the new reality of remote learning? Having sought to create the kind of refuge that fosters sharing, mindful processing, contemplative practice, and personal explorations into mortality and compassion, this holding space needed to continue to be available to students when in-person meetings were no longer possible.

The importance of the community of spiritual practitioners and its guiding teachers holds a preeminent place alongside the other two jewels: the Buddha himself, and his teachings (Dharma).

The Buddhist name for the spiritual community is the Pali term sangha. This is considered one of the “Three Jewels” in Buddhism. The importance of the community of spiritual practitioners and its guiding teachers holds a preeminent place alongside the other two jewels: the Buddha himself, and his teachings (Dharma). In the traditional sense of the term, sangha is seen to be the living community composed of fully ordained monks and nuns (generally a minimum of four or five), as well as novice monastics, supported by lay followers who worship there and receive dharma teachings.6 It is also seen to be a place of refuge where one’s spiritual understandings may increase during times of suffering and where confidence in the efficacy of Buddhist teachings and the lineage of Buddhist teachers and masters that have gone before can be reaffirmed. And, as we see from the Ratana Sutta, the wholesome perspective of a life in dharma and the encouragement provided by the sangha is seen to be a reason for genuine happiness and well-being.7

More recently in the West, the meaning of sangha has often been adapted to accommodate a more nontraditional view, that of a contemporary body of followers seeking teachings within the Buddhadharma and centered around a particular figure, monastic, or lay meditation teacher. Practitioners’ interests may range from learning meditation to studying Buddhist principles and praxis within a supportive community environment. These communities are usually organized as nonprofit entities supported by membership dues, donors, or particular programs of learning and study.8 In both traditional and nontraditional sanghas, a certain level of self-realization under the guidance of a senior teacher is assumed, and the fundamental “ordination” for teaching depends on the degree of insight one attains through one’s progress, faith, and the knowledge gained. In the more traditional context, these are usually combined with empowerments and a more formal ordination process authorizing one to teach dharma by one’s teachers or lineage-holders. Whether sangha is a helpful term in the more nontraditional sense is a discussion for another time and place—for our purposes, we will use this term in a more general way to convey an experience of community among Buddhist-oriented practitioners as led by learned and experienced teachers of Buddhism, meditation, and other forms of ritual or practice. Sangha in both contexts is meant to provide a refuge for spiritual companionship as well as a place for transformation to occur under the guidance of a Buddhist teacher.

In the eight years Cheryl and I have taught the class on Buddhist approaches to death and dying, a key aspect of the course has been to foster a feeling of sangha among students. Galvanizing the class around Buddhist teachings and a pedagogy of skillful means for ministry has in part relied on this sense of spiritual community as a place for transformative experience. Over the years, Cheryl and I have additionally collaborated on leading a number of weekend Buddhist retreats for caregivers involved in the work of living and dying, and we have sought to integrate some of these experiences into our classroom experiences at HDS. For example, during the first official meeting of the class, we hold a retreat that incorporates mindfulness meditation, chanting and singing, dharma talks, and the start of processing together some of the course material through council practice. Prompts involve students’ histories, their aspirations, meditation practice, and experiences with death and dying. The course is always held in the Divinity Hall chapel, with many students opting to sit on meditation cushions throughout the semester. And there is always hot tea available.

For some students, this format engenders a more impactful understanding of deep listening, empathy, and compassion through bearing witness to the experiences of others in the class, a somewhat atypical aim within the academic setting.

There exists a sense that the work we are doing in this community space can be profound and potentially transformative as we explore various Buddhist traditions around death and dying, mindfulness, and end-of-life care. For some students, this format engenders a more impactful understanding of deep listening, empathy, and compassion through bearing witness to the experiences of others in the class, a somewhat atypical aim within the academic setting. The spirit of sangha is integral to providing a refuge for spiritual formation here and relies on mutual support and contemplative practice in community to foster a deeper understanding of dharma and what Buddhism has to offer us in caring for the aging, the sick, and the dying.

Having begun the spring semester with a strong sense of this kind of learning in community, the abrupt transition to Zoom meetings seemed poised to significantly disrupt this process. The change from sitting together in a circle on meditation cushions in the chapel to sitting alone at home, with the class now an aggregate of boxes with faces on a computer screen, initially felt somewhat disconnected. And yet this was no different than the experiences among spiritual communities and sanghas alike during the “great migration.” This feeling, however, faded quickly. The presence of each student was a precious gift that remained, showing up each week with an open, wakeful heart experiencing a range of personal feelings and ultimate concerns.

The distancing provided by remote relating was unfolding in every other aspect of their lives, too. Concentration was difficult for many, a possible indicator of anxiety or trauma arising from the realities of a global pandemic. And many students struggled with writing the remaining papers. Some reported feeling isolated and cut off from friends or families, still others grappled with mysterious symptoms that may or may not have been COVID-related. It was essential for us, the instructors, to arrange ample time for personal check-ins with students and for processing the transition.

Everyone’s expectations needed to adapt just enough—including ours, the instructors—to continue to feel a sense of sangha reforming itself online. And so, the class continued to bear witness to each others’ fears and concerns.

As was common to many of the faculty at HDS, adapting to Zoom involved, above all, maintaining a consistent, regular sense of awareness of the well-being of our students. The time we spent checking in with them during each class session helped to maintain a sense of reliability, continuity, and peer support within a refuge previously established during our meetings in the Divinity Hall chapel. Every class session still included guided mindfulness practice and breathing exercises, as well as other contemplative approaches emphasizing lovingkindness (metta), compassion (tonglen), and equanimity (upekkha). These helped to maintain the spirit of the sangha that had begun on the cushions in the chapel. The use of Zoom “breakout rooms” still allowed for small group work, and class discussions explored how spiritual care might be considered effective in the absence of offering physical presence—a condition that is counterintuitive for many of us in the chaplaincy field. Papers were adjusted to include processing their experiences of the pandemic or reflecting on personal coping in whatever way would be helpful for them. Everyone’s expectations needed to adapt just enough—including ours, the instructors—to continue to feel a sense of sangha reforming itself online. And so, the class continued to bear witness to each others’ fears and concerns. Each person remained, bearing witness to the larger community of suffering, each bringing empathy, compassion, and wisdom into the heart of our time together.


Thus, the jewel in the lotus remained. Viewed through a Buddhist lens, the essence of our work together progressed mindfully, and deeper insights born of germane inquiry remained possible despite the opacity of the “mud” that has been the global pandemic. The cohorts of seekers and practitioners from various backgrounds that make up our classes at HDS most often strive to come together in a space of authenticity, compassionate aspiration, and a willingness to learn. In our class, this was set in the context of how to care skillfully for those at the end of life. The jewel remained unbroken, the lotus we grew together remained unsullied, and the water remained transparent despite the mud below.

Whether we regard the Buddha as the “Great Physician” or the “Great Provider of Spiritual Care,” he reminds us that both the first and the last step to the farther shore is one born of kindness and compassion. This is at the heart of what Buddhism can provide those seeking skillful means in spiritual care: the many precious teachings on caring for the sick, attending to the ailing body by healing the anguished mind, and showing up by embodying a mindful, contemplative presence in a transparent and authentic way.

The world will one day return to safety in physical closeness, I hope in a way that helps us to realize the preciousness of what it means to come together in embodied community. Sharing proximity within the sanghas of the various traditions we inhabit will occur alongside our classroom gatherings and the presence we once again provide in the spiritual care we offer. One thing is certain and gently suggests a simple wisdom of the heart: The jewel in the lotus is boundlessly resilient and shines with the clear light of 84,000 healing suns. May we know this to be our underlying nature, and may we know its potential to make us truly free despite the changing ripples within the pond.


  1. This is not her real name. All identifying characteristics have been altered.
  2. Bhikkhu Analayo, “Healing in Early Buddhism,” Buddhist Studies Review 32, no. 1 (2015): 22.
  3. For more on the concepts of becoming “self-less” and applying “beginner’s mind” to chaplaincy, see Chris Berlin, “Widening the Circle: Engaged Bodhicitta in Hospital Chaplaincy,” in The Arts of Contemplative Care: Pioneering Voices in Buddhist Chaplaincy and Pastoral Work, ed. Cheryl A. Giles and Willa B. Miller (Wisdom Publications, 2012), 81–91.
  4. The Book of the Discipline (Vinaya-Pitaka), vol. 4, Mahavagga, trans. I. B. Horner (The Pali Text Society, 1996), 433–34.
  5. It is interesting that the Buddha uses the phrase “from time to time” when describing the latter: providing spiritual conversation must arise from an attitude of lightheartedness or “gladness” as opposed to a sense of urgency or solemnity, as is often the case in many Buddhist exhortations to practicing dharma.
  6. See Peter Harvey, “Buddhist Practice: The Sangha,” chap. 10 in An Introduction to Buddhism: Teachings, History and Practices (Cambridge University Press, 1998), 217.
  7. “The Ratana Sutta: The Jewel Discourse” (Sn 2.1), trans. from the Pali by Piyadassi Thera, Access to Insight (BCBS Edition), November 30, 2013, www.accesstoinsight.org/tipitaka/kn/snp/snp.2.01.piya.html.
  8. Whereas sangha traditionally may refer more to the community of monks, nuns, and novice monastics, the Pali term parișā can also be used to refer to the wider Buddhist community, inclusive of all lay followers, in addition to the monastic cohort; see suttacentral.net/define/parisā.

Chris Berlin, MDiv ’06, is an instructor in ministry and spiritual counseling and the denominational counselor to Buddhist students at HDS and also teaches mindfulness, resilience theory, and compassion as a contemplative art at the Harvard Extension School. He is a contributing writer to the seminal volume in Buddhist pastoral care, The Arts of Contemplative Care: Pioneering Voices in Buddhist Chaplaincy and Pastoral Work, edited by Cheryl Giles and Willa Miller.

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