We sometimes call Shakyamuni the Great Physician, and of course many Mahayana Buddhists revere the Medicine Buddha. So I wondered how a buddha might run a hospital network.
For guidance, I turned to Peter Jones, whose book Design for Care: Innovating Healthcare Experience (Rosenfeld Media 2013) taught me a lot about healthcare delivery in the modern world. Peter teaches in the Strategic Foresight and Innovation program at the Ontario College of Art and Design, in Toronto, and is also a course leader in their Design for Health (MDes) program.
The subject of hospitals is of great concern these days because it is of vital importance to us. They are the locus of so much suffering and, for employees, courage and burnout during this pandemic. We call our frontline healthcare workers heroes now, but is it enough?
One of the first things I learned from Jones’s book is to view healthcare delivery as a system—beyond the obvious collective of employees who work there. His premise is that by understanding that system and making design improvements to it, we can enhance the experiences of those who avail themselves of its services and those who staff it.
Another key point is that a hospital is a nexus for many different types of health-seekers and their allies, and each requires a streamlined way to receive what they need without confusion amid the intersecting journeys of others at the same facility. We should not have to rely on heroic efforts by staff—the stuff of TV dramas—for them to function optimally. Nor should we see the staff as a homogenous impersonal service, since each individual within it is on their own career journey.
To this we can add our recent awakening to the role of supply-chain management as it pertains to vaccines, therapeutics, diagnostics, PPE, and so on. In other words, the system does not end at the hospital walls. We are all in this together. If some communities feel excluded from that togetherness, it is part of a systemic failure.
In this thought experiment, I then wondered how one might apply the same principles to institutions of Buddhist teaching and practice. What might a user experience (UX) designer say about the Buddha, the Dharma, and the Sangha? I have discovered that some are intrigued by the question, while others consider it akin to heresy.
Fortunately, UX designers abound, and there are even several international organizations devoted to promulgating their perspectives and advancing the profession. To learn more about how UX design works, I can recommend several such thought leaders including the Interaction Design Association, the Interaction Design Foundation, the Center for Excellence in Universal Design, and the Society for Experiential Design.
Traditional Buddhist paradigms involved teacher-student relationships that were sometimes personal but were for the most part institutional. However, in our literature, the personal relationships seem overly romanticized. How those institutions were—and are—run is an understudied area. The best book I have ever read on the subject was The Practice of Chinese Buddhism, 1900–1950 (Harvard University Press 1967), by Holmes Welch. He wrote two other books in the series, but that was the one that really stuck in my mind.
I would venture to say that this is an area needing further exploration. In the past two decades we’ve heard more than enough stories about errant Buddhist teachers, about how to confront and combat prejudice in our communities, and about how to hold fast in these turbulent times.
Hence, I imagine that many sanghas are struggling to find their strengths, independent of charismatic teachers, and how to structure their communities for resilience.
In this, I see a lot of parallels with how UX designers view hospitals.
A document recently arrived in my email inbox, titled Latest Revised Guidelines for Students of the Venerable [teacher’s name]. . . . It is 23 pages long! I read the entire thing twice but was puzzled about why there was no section on guidelines defining what Dharma teachers commit to uphold on behalf of their students. Nor was there a section on how community members should relate to one another. This student-centric focus without teacher accountability or more than perfunctory sangha consideration was disturbing to me, in spite of the fact that I have known this particular teacher for 40 years and respect him highly.
On the other hand, I have seen some excellent guideline documents, although not many. The Soto Zen Buddhist Association Statement of Ethics is one such well thought-out example.
It may be a truism to say that our Buddhist communities exist within the larger community, and that they are interdependent. However, I think it is worth emphasizing because in my experience, many of the Buddhist communities with which I am familiar tend to function as hermetically sealed vessels, or at least they present obstacles for many types of interaction except within a limited repertoire of roles. Heaven knows, my relationship with the Buddhist institutions that I hold dear is far from commonplace—I can’t see myself in many of those set-ups.
To use the hospital analogy again, not everyone is there for the same thing or seeking to benefit in the same way. We are all coping right now with a great, multifactorial disturbance to our expectations of how reality is supposed to work. It’s a mess. Institutions are under types of strain that they were not—at least in our lifetime—built to withstand.
The point is: a one-size-fits-all approach to Buddhist practice does not work. That’s why we say the Dharma exists for the 84,000 types of beings. Buddhist teachers similarly do their best to live their deepest wisdom and compassion in their own ways. Surely each individual has a place in our communities where they can build on their strengths for the benefit of themselves and others. This non-uniformity of experience in religious communities is nothing new. William James wrote about it in The Varieties of Religious Experience: A Study in Human Nature (Longmans, Green, and Co. 1902).
Running a religious community is a service, not a product. So if the role of community leaders is to respond to the needs of their communities, they must assume the perspective of experiential designers to facilitate that.
To say that Buddhism is about identity misses the multi-dimensional nature of practice. To say that Buddhism is about the path to Enlightenment misses what comes after such peak experiences. The Middle Way is not difficult, but only for those who avoid being trapped in such dualisms. In fact, it is transcendent. But of course, we are all too familiar with that anecdote about mistaking the finger for the moon.
Consider, if you will, the training of chaplains, working as they do in complex institutions like hospitals, and being of service to a highly diverse clientele of care-seekers. Could we apply the same lens to Buddhist teachers within and beyond their own sangharamas? Could we think about Buddhist practitioners as having agency and presence in the wider world too?
Where does all this leave us? We might ask ourselves what sort of experience we expect from a Dharma center, or Buddhist studies course, or how we might integrate that with our day-to-day lives.
More to the point: if we want to actualize those traits in our own teaching and communities, we need to model those skills ourselves. And that means we need to learn how to be good experiential designers ourselves, not just from within our own traditional paradigms, but also from secular professionals and organizations who work in this space.
Could we go so far as to say Shakyamuni is the Great UX Designer? Probably, even if traditionalists may tsk-tsk the idea.
Design for Care: Innovating Healthcare Experience (Rosenfeld Media)
Interaction Design Association
Interaction Design Foundation
Center for Excellence in Universal Design
Society for Experiential Design
Soto Zen Buddhist Association Statement of Ethics (Web Archive)