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How to Make Sickness your Practice

Excerpted from Toni Bernhard's How to Be Sick. In this book, Bernhard shares ways to make “being sick” the heart of a spiritual practice — and through truly learning how to be sick, learn how to live a life of equanimity, compassion, and joy. In the selection below, she contemplates the Buddha’s teaching that life is suffering.


After a long and winding journey of discovery with many ups and downs, the Buddha, an ordinary human being like you and me, sat down under a tree for a long time, and then he attained enlightenment — also known as liberation, freedom, or awakening. At first he wasn’t sure if he could find the words to share his discovery, but eventually he gave his first teaching in the form of the Four Noble Truths. Buddhism — what Buddhists call the Dharma, which simply means “teachings”— was born.

Many people will tell you they know the first noble truth, but their usual rendering,“Life is suffering,” is responsible for a lot of misunderstanding about what the Buddha taught. In offering us the first noble truth, the Buddha was not making a negative pronouncement. If so, it’s hard to imagine why he would have called it “noble.”

“Life is suffering” is misleading for at least two reasons. First, the Buddha used an ancient Indian language similar to Sanskrit called Pali, and the word he used in Pali for the first noble truth, dukkha, is difficult to translate. Dukkha is too multifaceted and nuanced a term to be captured in the one-word translation “suffering.” And second, the fact of dukkha in our lives doesn’t mean that life is only dukkha.

To capture the essence of what the Buddha meant by the presence of dukkha in our lives, it’s helpful to keep other possible translations of this key word in mind: unsatisfactoriness (that is, dissatisfaction with the circumstances of our life), anguish, stress, discomfort, disease, to name just a few. Dukkha is a term worth becoming familiar with, especially when exploring how to be sick. When I first encountered the various translations for dukkha, they resonated powerfully for me. Finally, someone was describing this life in a way that fit a good portion of my experience, both physical and mental: stress, discomfort, unsatisfactoriness. What a relief to know it wasn’t just me, or wasn’t just my life!

The feeling that the Buddha understood the pain of my life allowed me to start the day-to-day work of accepting that dukkha is present for all beings. Even in the darkest early days of the illness, when I didn’t understand what was happening to me (was I dying?), I always had the first noble truth propping me up, telling me, “You know this is the way it is.You were born and so are subject to change, disease, and ultimately death. It happens differently for each person.This is one of the ways it’s happening to you.”

I’ll never forget listening to Spirit Rock teacher John Travis giving a talk on a ten-day retreat. He suddenly stopped talking and slowly scanned the room, making eye contact with every single one of us. Then he very gently said,“I know you. We all know each other. We’ve all had our hearts broken by the relentless search to avoid suffering.” I would only add that this relentless search just brings more suffering because dukkha is an aspect of existence for all living beings born into this world.

The first noble truth — the fact of dukkha — helps me accept being sick because that fact tells me my life is as it should be. “Our life is always all right,” says Zen teacher Charlotte Joko Beck. “There’s nothing wrong with it. Even if we have horrendous problems, it’s just our life.”

Joko Beck points out that the second part of the word suffer (-fer) is from the Latin verb ferre, which means “to bear” and that the first part (suf-) is from sub, meaning “under.”Taking this view, dukkha is not about life bearing down on us from the outside, but instead dukkha is an internal phenomenon of bearing life up from underneath. Joko Beck writes:

So there are two kinds of suffering. One is when we feel we’re being pressed down; as though suffering is coming at us from without, as though we’re receiving something that’s making us suffer. The other kind of suffering is being under, just bearing it, just being it.

Just “being” life as it is for me has meant ending my professional career years before I expected to, being house-bound and even bed-bound much of the time, feeling continually sick in the body, and not being able to socialize very often. Using Joko Beck’s teaching, I was able to use these facts that make up my life as a starting point. I began to bow down to these facts, to accept them, to be them. And then from there, I looked around to see what life had to offer.

And I found a lot.

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Got her latest - How To Wake Up

I don't have this one but I got Tony's latest How to Wake Up. It is brilliant! Covers most of the main areas of Buddhism and unlike a lot of other books uses simple, modern language. Highly recommended!

Great to hear this,

Great to hear this, mscoree42! We're excited for her new book coming out with us this fall: How to Live Well with Chronic Pain and Illness. We'd love to hear what you think of it.


Minneapolis, MN

Your sharing is really helpful! Thanks Wisdom!

So glad to hear this! You're

So glad to hear this! You're welcome, and thanks for your comment.

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