By Dr. Bhaswati Bhattacharya
PK is the common western slang for Panchakarma, indicating that the once-esoteric treatment process is now gaining popularity in mainstream America. Everyone wants to get on the bandwagon, whether they are physicians, ayurvedic drug manufacturers, IT communications start-up engineers, wealthy patient enthusiasts, or SEO optimizers.
In an effort to popularize Panchakarma, many get involved thinking they will just hire components for the endeavor, just as they hire professionals in any industry. They price out oils, drugs, hotel-type furniture, and spa equipment, and get excited about setting up a restaurant in the facility as well as providing things that will attract customers. What they often think is easily obtainable is a trained and credentialed bunch of karma therapists and Pancha-karma physicians, as well as Ayurvedic physicians specializing in lifestyle and food, known as swasthvritta. But once they do a sensitivity analysis and realize the human capital costs of PK, business-minded owners begin to gravitate toward the minimum expenditure needed to turn a profit.
They hire business consultants that often request luxuries for the patients in order to fill the room and keep them happy so they will give good recommendations. Business people who cannot understand the true underlying processes of Panchakarma are themselves contraindications for treatment, destroying the sanctity of the process! A good Panchakarma center does not have many luxuries or conveniences, especially because many are actually contrary to the natural dinacharya needed when a person is undergoing intense therapy.
The healing of the patient, because it cannot be evaluated, drops to a low priority.
Today, therapists who are not so well-trained will simply get the credential required by law, and open a clinic or outpatient Panchakarma center in which they treat people in amateur ways. They do not follow through to ensure the patient completed the full Panchakarma process as written in the ancient texts. Patients cut corners. Physicians cut corners.
The two most common indications of a botched Panchakarma journey are a person who regains the weight they lost within 2-3 months–the time of the last phase of the Panchakarma process, or have aggressive relapses of the disease that started to wane; and gut symptoms such as bloating, indigestion, diarrhea, and irritable bowel. These indicate that the physician did not convey properly the prescriptions for restoring the digestive fires that are purposefully suppressed during Panchakarma. All too often, the physician writes a prescription that is not understood fully by the patient.
Another common mistake is the use of oils on every patient on arrival, to calm their Vata and allow them to begin the new experience of hot oil massages that they were covetously awaiting. External warm oil, especially sesame oil, on the skin only spreads toxins more quickly. This only aggravates people with deep-seated skin diseases, autoimmune diseases, and very low immunity.
An excellent physician will evaluate the pulse and tongue of the patient, along with several other variables, chart a course that will be very specific for the first two days and generally outlined for the duration of the treatment. The usual duration for a first-time visitor is 28-35 days. For serious conditions, treatment may take as long as six weeks. But even for a tune-up, no one should be undertaking Panchakarma for less than 14 days.
Understanding how to prepare for Panchakarma is another blunder. Most centers do not orient the patient and show them how to prepare in the initial phase known as pre-purvakarma. The oral intake of ghee with key observations of appetite, bowel movements, energy level, cravings, and emotions allow the physician to understand how dry a person’s cellular boundaries are. Too much ghee will destroy the digestive fire, just like pouring too much oil over a campfire.
So what does it mean when a person says that they did a weekend Panchakarma or a seven-day punch karma package? It means that they got partly cleaned out and then the rest of the sludge that was collected is allowed to scatter once again in the body.
Ayurveda is in dire need of health coaches, known as upasthatha in Ayurveda. These people serve as bridges between the technical thinking of the physician, and the practical needs from the perspective of the patient. In the modern world, such health coaches could bridge the understanding that patients who have never undertaken Panchakarma need.
Dr. Bhaswati Bhattacharya