In the Cage of Freedom
DR. BOONLOET CHUNTARAPAS
Former Director, Phramongkutklao Hospital and Former Special
Advisor to the Supreme Command Headquarters
Medical professionals are known to endure a lot of stress. The level of stress is even higher when the work concerns surgery, particularly brain surgery. As a highly sought-after neurosurgeon, Dr Boonloet Chuntarapas found himself often entrusted by senior doctors and the management to be in charge of important cases and tasks since the early days in his career. At 48, he was already appointed as director of Phramongkhutklao Hospital, a public hospital that caters specifically to military personnel to bring change to the organization.
Despite distrust and scrutiny from his subordinates and older, highly experienced colleagues, the newly appointed director decided to take up the challenge. He introduced several reforms to the hospital’s services and management system, and was finally accepted. As he was climbing the stairs of life, he learned to turn the pressure and restrictions into motivation to improve himself and help others in need.
Now at 71, Dr. Boonloet is still active working as an acupuncture specialist at Vibhavadi Hospital where he is also an Independent Director.
What made you interested in brain surgery?
Initially, I was interested in neurosurgery because I thought it can help more people. Almost all cases will have to go through neurosurgery at some point but there was a shortage of brain surgeons at that time. My senior asked me if I was interested so I agreed to undergo the training at a hospital near Pramongkhutklao Hospital. There were a lot of patients with brain conditions from many places, mostly tumor cases.
At that time, I worked at two hospitals. When I was at the Pramongkhut, I was on night shift at the accident ward. That experience has improved my learning curve in surgery because my main responsibilities were neurosurgery (brain and spine).
You also volunteered to join the royal mobile medical team project. Why did you become interested in it? How different was it compared to the hospital environment?
In those early days, there were conflicts on the border in Arayaprathet district. When I was a doctor in the Pramongkhut Hospital, there was no doctor stationed at the border area. Every month, a doctor from the hospital would be deployed there for a month. At that time, former Commander-in-Chief Gen Arthit Kamlang-ek, then a Major General, had cervical spondylosis leading to loss of muscle control. So I performed a surgery on him and was asked to stay on. For that entire year, I was stationed there, taking care of cases from Arayprathet and Wattananakorn to Sakaeo province.
I became the main surgeon for all brain trauma cases, each of which very difficult and involving serious injuries. Later, I also volunteered for the royal mobile medical team. Wherever I went, there were a lot of people in need of help. That’s when I started to thinking of what I could do more to help.
Is seeing a lot of suffering part of the reason why you became interested in Vipassana meditation?
I prayed from time to time but didn’t practice meditation at all. But when I rose to a senior position, I thought this was the time I could do many things. I was brushing my teeth one morning and then an idea about a project to support monks came up. Monks had fewer accesses to medicine and treatment than ordinary people. Their only channel to receive treatment is the Priest Hospital. Going to other hospitals is inconvenient because of their status.
This project was like a mobile hospital with X-ray machine, equipment for operations, tools for blood and heart tests. There were also ophthalmologists and orthopedists. The service will cover all the monks at the temple we go.
What happened was when people knew about it, they began pitching in, bringing foods and medicine to help us. Everywhere we went, we didn’t use the government money at all. Every cent came from public donations. Everything was free. Do you know what was the best part? They were given amulets and other lucky charms (laugh). Another project I initiated was a meditation program for medical students. There was also a mass ordination ceremony for those interested.
So, if you ask me when my Dhamma practice began, I’d have to say, ‘After retirement.’ The first time I sat down to meditate, it was so painful I could die (laugh). Couldn’t do it at all, the soreness, the pain. It was later that I developed some patience.
A surgery on brain and spinal cords requires high precision and speed. When your work demands hours of extremely long focus, shouldn’t it make meditation easier?
It does help a lot. All you just have to do is stay focused on the focal point. That’s all there is. When your mind stops wandering, you won’t be mentally tired.
In fact, brain surgery is the kind of work that is confined to a very small area. You need to be quick. The faster you are, the higher the survival rate is. What meditation masters say about keeping your focus at one point is the same to surgery. You can’t take your eyes off the surgery point. Your attention must be fixed there particularly when it’s a brain surgery as there’s a lot of bleeding. You need to race against time. What happened over time was that I could finish it very fast. Some doctors need 4-5 hours but I needed only one hour or 1.30 hour.
It also helped when you were young and played sports DR. BOONLOET CHUNTARAPAS99 as it helped develop your reaction time. I only realized later that the best training it gave was concentration power that develops into great consciousness.
It’s interesting that although you didn’t practice meditation, you promoted it and even launched a meditation program for medical students. Why was that?
It was the hectic work schedule. But some attitudes and values of medical students these days are quite off. After a meditation retreat, their attitudes were better… It was a shame I didn’t get to start meditation in my 30s. Otherwise, I would have used a lot of Dhamma principles in my work life. You know what? I was appointed as Hospital Director when I was 48. Usually, doctors at this age are either a director-general of a unit or director of a provincial hospital. But I was made to manage senior doctors who were also professors or graduates from overseas.
What was it like being a young boss?
What happened in the last 12 years (before retirement) was extreme exhaustion. I couldn’t make mistakes, had to be good all the time because everyone was watching both openly and secretly. The majority of complaints and anonymous letters were directed at me. Luckily, I could prove that they were all baseless because I had learned to be prudent in my work. Mistakes usually happen when you’re not careful enough. Those people who kept finding fault in me were like pineapples (laugh). Their eyes were everywhere. But it motivated me to keep doing better. The pressure and restriction acted like a frame with guidelines, keeping me in check.
And which part of issues that you think meditation would be of great help?
Compassion. I wish doctors, nurses, and hospital staff had more compassion. When you have more kindness, you want to help more. If the hospital staff want to help more, they will smile the moment a patient walked in because this is another opportunity to help others. A call in the middle of the night will not upset them either.
Today, it’s the opposite. Medical students and young doctors today often ask first whether doing this and that will benefit them. Recently, I’ve visited Thawsi School. It’s an elementary school that bases its teaching approach on Buddhist way to cultivate moral conscience in children. The learning process there starts with: What do you study? Why do you study it? And how can you use it to benefit others and the society? These questions are what we should ask ourselves when we start something whether it’s school, work, or any other things.
But the most popular schools are currently cosmetic surgery and dentistry because they make a lot of money and quickly too.
Well… (laugh). It all comes down to how they were raised. The new generation of doctors don’t know how to have a conversation with patients anymore. A few words and they write down a prescription. But if they talk to the patient, they will know better how to treat him. They have a break, they grab the smartphones.
Are you saying that patients are seen more as cases, rather people with flesh and blood?
What they think is being a doctor is a good career choice. But there are fundamental principles in medical diagnosis. If they no longer touch or talk to their patients, how could they make an accurate diagnosis? I’ve even seen many of them enjoy playing fighting games, with piles of dead bodies. Where can they cultivate compassion?
Anything else about meditation that can help?
Ego. People with power and honor usually have low intolerance with others (laugh). I was always told that I look stern and strict, but now softened up.
I’ve also learned to take it slow when it comes to Dhamma practice. We just have to keep practicing our mind. No need to hurry. The results will follow. I have this habit of self-monitoring by asking, “Is your glass full of water? Have you stopped listening to others lately?” In the evening, I will sit down and reflect on how my day went, whether it went wrong or needs to make change.
The self-taught habit is very valuable. People are increasingly lonely or on their own more than in the past. How can we cultivate this habit?
My childhood was rather lonely because I was raised mostly by my grandmother and surrounded by adults. I often spent my time observing things around me. When I grew up, my thoughts became less random and more useful, thanks to my brother who always helped guide me.
When I studied Dhamma, the advice I liked the most is that before you do something, you must have faith, perseverance, and attention…so my advice is you need to surround yourself with good people. What the new generation lack is full awareness of themselves, of their surroundings. With the awareness, we react to everything. If you’re in a bad environment, it’s very easy to take the wrong path.
But I think my success is mainly because I know how to deal with boredom. When people are bored, it means they’re unsatisfied with the current situation. It’s time to look for something new and challenging. That’s your opportunity to grow. That’s why I didn’t think it was that bad to be constantly monitored. The scrutiny and skepticism stimulated me to improve myself, to stay inside the line.
Let’s say I’m surrounded by a wall that looks like this, so if I want to see something new and different, I just need to increase my standard. I will then do what it takes to raise that limit higher.
