My personal faith

This week the faith column is devoted to the Jain religion with Ashik Shah outlining what he believe

From the earliest age, I have always been curious, and used to wake my parents at 5am when I was 5 with questions about god. Apart from a fascination with many subjects, I have always had a love for the spiritual and religious.

As a teenager and young adult I had always tried to read as much as I could about religious figures and various religions. While I knew that my family was Jain by history and that my grandmother, who lived with us, practiced this is many ways, it was all a different world to me.

Little material was available in English and very few coherent explanations. On the other hand, much insight was available into the Abrahamic faiths, given that I went to a school whose explicit confession was Church of England. Much was available on Buddhism and Hinduism too. I remember an early fascination with Mahatma Gandhi, who I viewed as an embodiment of goodness of character and conduct, who put his ethics into dynamic action. Unfortunately, very little information was accessible in English on Jainism, a situation which is now beginning to change.

My fascination for Jainism remained alive, in my admiration for the unique compassion of Jain practice, where even the smallest life form is accorded respect, its antiquity, and the example of Lord Mahavira (about whom we will discuss more in the blog on Jain history).

When I considered his person, I remembered his profound serenity and equanimity during the various ordeals he faced in his life, as told to us as children, and was inspired to understand more of the path to inner peace which he taught.

I have been fortunate in my life to have met a number of spiritual leaders who had shared with me the importance of a spiritual perspective.

They all inspired me to study the faith in more detail. I did find a number of scholarly and academic books in English and dedicated some time after University to study works in Gujarati, my mother tongue, a language of Western India, in which there is much Jain literature.

I found this very frustrating, but eventually very fruitful. I became gradually more confident at the ability to actually engage in a conversation in Gujarati with any spiritual leader I encountered, so I could have my questions answered.

It was at this time, that I became more aware of the writings of a relatively modern Jain personality. Shrimad Rajchandra (1867-1901) lived a very short and spiritually productive life.

He was Mahatma Gandhi’s spiritual guide and mentor, a fact little appreciate in the West, and Gandhiji has said a lot about him in his autobiography, other writings and speeches. He hailed from Gujarat and was a householder, ostensibly engaged in business. However, from the earliest age he was engaged in spiritual enquiry.

For me, the most significant fact is that Shrimad Rajchandra gained a direct experience of his Soul through his spiritual meditative practice, a state Jains term Samyak Darshan, or Self-realisation. Of great value is the fact that during with a number of seekers with whom she shared intimate correspondence and spiritual guidance. Shrimad’s legacy is his living example and his writings. It is very rare to find the intimate correspondence and inner thoughts of one who is self-realised.

I have taken as my guru, Shri Nalinbhai Kothari, from the Raj Saubhag Ashram in Gujarat, India. This Ashram is part of a continuous living tradition of gurus from the time of Shrimad, starting with his soul-mate Shri Saubhaghbhai of Sayla.

My personal practice consists, as guided by my guru, in the daily recitation of certain prayers, reading, contemplation and meditation, in addition to the acts of worship and duties of a Jain householder. Meditation is the highlight of my day, as it brings a great sense of peace to me. While I know I know that this meditation I practice is not necessarily the direct experience of soul, I do know that it will help in calming my mind and purifying my consciousness, so I can progress further towards my goal.

Of course, I have a long way to go in my journey. I would describe myself as an aspirant at best, and one whose discipline is not as strong as it could be. However, I do have full faith in the path I have chosen. As I cultivate certain virtues, I will become calmer and more detached, and more insightful. My life will benefit from more equanimity, as well as calmness. When I consider the serenity, peace, and bliss which are all intrinsic to my very nature, as a living being, I am able to put mundane matters into perspective.

I do believe that spirituality is beyond sectarianism, and my Guru has often taught me, as has the Jain doctrine of Anekantavada (to be discussed later in the blog), or multifaceted nature reality, to take the best from all teachings and insights. I believe that spirituality is beyond ritual, or scholarship, but does take support from such practices.

Through the guidance of my Guru and through my reading and contemplation, I feel I have been able to understand better the abstract ideas presented about the path. It is difficult to imagine the bliss and contentment brought about by the ecstasy of self-realisation, until one is able to see its living embodiment. This in turn makes it much easier to grasp the majesty of the Soul and the power of total equanimous detachment which Enlightenment brings, as seen in the lives of Lord Mahavira and those who have gone before.

Ashik Shah is an active lay member of the Jain community. He was a founder of Young Jains of America, and is an active member of Young Jains in the UK. He has been in the fund management business for the last 15 years.
Flickr/Michael Coghlan
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Why does the medical establishment fail to take women in pain seriously?

Women with mesh implants have been suffering for years. And it's not the only time they have been ignored. 

Claire Cooper’s voice wavered as she told the BBC interviewer that she had thought of suicide, after her mesh implant left her in life-long debilitating pain. “I lost my womb for no reason”, she said, describing the hysterectomy to which she resorted in a desperate attempt to end her pain. She is not alone, but for years she was denied the knowledge that she was just one in a large group of patients whose mesh implants had terribly malfunctioned.

Trans-vaginal mesh is a kind of permanent “tape” inserted into the body to treat stress urinary incontinence and to prevent pelvic organ prolapse, both of which can occur following childbirth. But for some patients, this is a solution in name only. For years now, these patients – predominantly women – have been experiencing intense pain due to the implant shifting, and scraping their insides. But they struggled to be taken seriously.

The mesh implants has become this month's surgical scandal, after affected women decided to sue. But it should really have been the focus of so much attention three years ago, when former Scottish Health Secretary Alex Neil called for a suspension of mesh procedures by NHS Scotland and an inquiry into their risks and benefits. Or six years ago, in 2011, when the US Food and Drug Administration revealed that the mesh was unsafe. Or at any point when it became public knowledge that people were becoming disabled and dying as a result of their surgery.

When Cooper complained about the pain, a GP told her she was imagining it. Likewise, the interim report requested by the Scottish government found the medical establishment had not believed some of the recipients who experienced adverse effects. 

This is not a rare phenomenon when it comes to women's health. Their health problems are repeatedly deprioritised, until they are labelled “hysterical” for calling for them to be addressed. As Joe Fassler documented for The Atlantic, when his wife's medical problem was undiagnosed for hours, he began to detect a certain sexism in the way she was treated:

“Why”, I kept asking myself, when reading his piece, “are they assuming that she doesn’t know how much pain she’s feeling? Why is the expectation that she’s frenzied for no real reason? Does this happen to a lot of women?”

This is not just a journalist's account. The legal study The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain found that women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively. 

An extreme example is “Yentl Syndrome”. This is the fact that half of US women are likely to experience cardiovascular disease and exhibit different symptoms to men, because male symptoms are taught as ungendered, many women die following misdiagnosis. More often than should be acceptable, female pain is treated as irrelevant or counterfeit.

In another significant case, when the news broke that the most common hormonal birth control pill is heavily linked to a lower quality of life, many uterus-owning users were unsurprised. After all, they had been observing these symptoms for years. Social media movements, such as #MyPillStory, had long been born of the frustration that medical experts weren’t doing enough to examine or counter the negative side effects. Even after randomised trials were conducted and statements were released, nothing was officially changed.

Men could of course shoulder the burden of birth control pills - there has been research over the years into one. But too many men are unwilling to swallow the side effects. A Cosmopolitan survey found that 63 per cent of men would not consider using a form of birth control that could result in acne or weight gain. That’s 2 per cent more than the number who said that they would reject the option of having an annual testicular injection. So if we’re taking men who are afraid of much lesser symptoms than those experienced by women seriously, why is it that women are continually overlooked by health professionals? 

These double standards mean that while men are treated with kid gloves, women’s reactions to drugs are used to alter recommended dosages post-hoc. Medical trials are intended to unearth any potential issues prior to prescription, before the dangers arise. But the disproportionate lack of focus on women’s health issues has historically extended to medical testing.

In the US, from 1977 to 1993, there was a ban on “premenopausal female[s] capable of becoming pregnant” participating in medical trials. This was only overturned when Congress passed the National Institutes of Health (NIH) Revitalisation Act, which required all government funded gender-neutral clinical trials to feature female test subjects. However, it was not until 2014 that the National Institutes of Health decreed that both male and female animals must be used in preclinical studies.

Women’s exclusion from clinical studies has traditionally occurred for a number of reasons. A major problem has been the wrongful assumption that biologically women aren’t all that different from men, except for menstruation. Yet this does not take into account different hormone cycles, and recent studies have revealed that this is demonstrably untrue. In reality, sex is a factor in one’s biological response to both illness and treatment, but this is not as dependent on the menstrual cycle as previously imagined.

Even with evidence of their suffering, women are often ignored. The UK Medicines and Healthcare Regulatory Agency (MHRA) released data for 2012-2017 that shows that 1,049 incidents had occurred as a result of mesh surgery, but said that this did not necessarily provide evidence that any device should be discontinued.

Yes, this may be true. Utilitarian thinking dictates that we look at the overall picture to decide whether the implants do more harm than good. However, when so many people are negatively impacted by the mesh, it prompts the question: Why are alternatives not being looked into more urgently?

The inquiry into the mesh scandal is two years past its deadline, and its chairperson recently stepped down. If this isn’t evidence that the massive medical negligence case is being neglected then what is?

Once again, the biggest maker of the problematic implants is Johnson&Johnson, who have previously been in trouble for their faulty artificial hips and – along with the NHS – are currently being sued by over 800 mesh implant recipients. A leaked email from the company suggested that the company was already aware of the damage that the implants were causing (Johnson&Johnson said the email was taken out of context).

In the case of the mesh implants slicing through vaginas “like a cheese-wire”, whether or not the manufacturers were aware of the dangers posed by their product seems almost irrelevant. Individual doctors have been dealing with complaints of chronic or debilitating pain following mesh insertions for some time. Many of them just have not reported the issues that they have seen to the MHRA’s Yellow Card scheme for identifying flawed medical devices.

Shona Robison, the Scottish Cabinet Secretary for Health and Sport, asked why the mesh recipients had been forced to campaign for their distress to be acknowledged and investigated. I would like to second her question. The mesh problem seems to be symptomatic of a larger issue in medical care – the assumption that women should be able to handle unnecessary amounts of pain without kicking up a fuss. It's time that the medical establishment started listening instead. 

 

Anjuli R. K. Shere is a 2016/17 Wellcome Scholar and science intern at the New Statesman

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