Mayo Clinic is a not-for-profit medical practice and medical research group based in Rochester, Minnesota, specializing in treating difficult cases (tertiary care). Patients are referred to Mayo Clinic from across the U.S. and the world, and it is known for innovative and effective treatments. Mayo Clinic is known for being at the top of most accredited quality standard listings; for example, it has been near the top of the U.S. News & World Report List of Best Hospitals for more than 20 years.^[1] The practice is distinguished by integrated care, and a strong research presence is evidenced by the fact that over 40% of its resources are devoted towards research (rather than just medical practice).

Mayo Clinic has been on the list of America's "100 Best Companies to Work For" published by Fortune magazine for eight years in a row.^[2][3] From its humble beginnings as a family venture between a father and his two sons, the practice later became America's first integrated group practice, a model that is now standard in the United States. The current-day Mayo Clinic is an integrated practice of more than 3,700 physicians and scientists, and a total employment including nurses, students, and allied health staff of more than 56,000 persons.^[4]

History[link]

William Worrall Mayo, the founding father of what would become the Mayo Clinic.

Early Years[link]

In 1863, William Worrall Mayo (1819–1911) came to Rochester, Minnesota as part of his appointment as an examining surgeon for the military draft board during the Civil War. The city would be to his liking, and his wife and children would join him in early 1864. W.W. Mayo opened his medical practice after the war, and would also serve in several leadership roles in the community. Both of W.W. Mayo's sons, William James Mayo (1861–1939) and Charles Horace Mayo (1865–1939) would grow up in Rochester, and when old enough both attended medical school. William (Will) graduated in 1883 and joined his father's practice, with Charles (Charlie) joining after he completed his training in 1888.

Bronze statue of the Mayo brothers, "Dr. Charlie" (left) and "Dr. Will" (right), in front of the Mayo Clinic Gonda Building in Rochester, Minnesota

On August 21, 1883, a tornado struck Rochester, causing at least 37 deaths in the area and over 200 injuries.^[5] One-third of the town was destroyed, but the Mayo family escaped serious harm. The relief efforts began immediately with a temporary hospital being established at the city dance hall, and the doctors Mayo (W.W. and Will) were extensively involved in treating the injured who were brought there for help. Mother Alfred Moes and the Sisters of Saint Francis (a teaching order) were called in to act as nurses despite having been trained as teachers and with little if any medical experience.

After the crisis had subsided, Mother Alfred Moes approached W.W. Mayo about establishing a hospital in Rochester if he agreed to staff the hospital. On September 30, 1889, Saint Marys Hospital was opened. Dr. W.W. Mayo (who by this time was 70 years of age) became the consulting physician and surgeon at the hospital, and his two sons began seeing patients and performing surgeries with the assistance of the Sisters of Saint Francis.^[6]

Group Practice[link]

In 1892, Dr. Augustus Stinchfield was asked to join the practice by W.W. Mayo, who considered him to be the best doctor in the small towns surrounding Rochester. After Dr. Stinchfield joined the practice, W.W. Mayo retired at the age of 73. The group practice would continue to grow, eventually adding other physicians considered today as the "founders" of the Mayo Clinic. The earliest members of the group included Mayo brothers Will and Charlie, Dr. Stinchfield, Dr. Graham, Dr. Henry Plummer, Dr. Millet, Dr. Judd, and Dr. Balfour. These early partners shared in the profits of the private group practice, while other staff hired by the partners were salaried. W.W. Mayo died in 1911, but the group practice continued strong with an ever increasing presence nationally as a cutting edge center, particularly in the area of surgery. In 1919, the group partners created the Mayo Properties Association, and their private practice became a not-for-profit entity. The Mayo Brothers, who had retained ownership of all Clinic properties and furnishings, gave everything to this newly formed association. The integrated practice model of the original partners created a foundation for what would grow into the Mayo Clinic.

Growth and Current Practice[link]

The Group Practice continued steady growth throughout the 20th Century. The campus continued to grow to keep up with patient numbers and an increasing research focus of the Clinic's operations. In 1928, the Plummer Building was completed with considerable input from Clinic staff, and under the guidance of Dr. Henry Plummer (designed by John William Dawson and Ray Corwin from the architectural firm of Ellerbe & Round). At the time of its completion, it was the tallest building in Minnesota and remained so until the Foshay Tower was finished in Minneapolis in 1929. It was added to the National Register of Historic Places in 1969, and has recently undergone a complete restoration of its bell tower. The Ellerbe firm is the architect of record for the 1914 Mayo "Red" building, the 1922 Mayo Institute of Experimental Medicine, the 1927 Plummer building (completed in 1928), the 1954 Mayo Clinic building, and the 2002 Gonda building. The historic 1914 "Red" Mayo Clinic building, a National Landmark listed on the National Register, was demolished by the Clinic in the 1980s to make way for the HGA designed Siebens building. Since 1986, the Mayo Clinic campus has formally included the Rochester Methodist Hospital and Saint Marys Hospital, as all operations were integrated under one governing board to more efficiently serve the needs of Mayo patients.^[6] In 2011, the foundation went before the Supreme Court to argue that medical residents should remain exempt from Social Security deductions. In Mayo Foundation v. United States the court sided with the Social Security Administration and required FICA to be deducted going forward.

The Mayo Clinic is a member of the Consortium of Academic Health Centers for Integrative Medicine(CAHCIM).^[7][8] The stated mission of the CAHCIM is "to advance the principles and practices of integrative healthcare within academic institutions. The Consortium provides its institutional membership with a community of support for its academic missions and a collective voice for influencing change."^[9]

Locations[link]

The Plummer Building in Rochester, Minnesota.

Mayo Clinic has a large presence in three U.S. metropolitan areas: Rochester, Minnesota, Jacksonville, Florida, and Scottsdale/Phoenix, Arizona. The Clinic employs more than 32,000 people at the main campus in Rochester, Minnesota and is a major source of economic power.^[4] The Arizona and Florida sites employ approximately 5,000 persons at each site. In addition, the Mayo Clinic owns and operates the Mayo Clinic Health System, which consists of more than 70 hospitals and clinics across Minnesota, Iowa, and Wisconsin with an employment of 14,000 persons. Mayo Clinic also operates several colleges of medicine, including Mayo Medical School, the Mayo Graduate School, and the Mayo School of Graduate Medical Education, Mayo School of Health Sciences.

Core values[link]

As is evidenced by the Mayo Clinic logo, the institution has a three part focus. First and primary to the organization is the patient care practice, represented by the central shield. This is in accordance with the primary statement of the organization that "the needs of the patient always come first." The other two shields represent the areas of education and research, two areas of Mayo Clinic which have become more prominent over time.^{[citation needed]}

Patient care[link]

Each year, more than one million patients from all 50 states and from more than 150 countries are seen at one of the Mayo Clinic facilities.^[4] Mayo Clinic offers highly specialized medical care, and a large portion of the patient population are referrals from smaller clinics and hospitals from across the upper Midwest and the United States as a whole. Mayo Clinic physicians are paid a fixed salary that is not linked to patient volume (relative value units) or income from fee-for-service payments. This practice is thought to decrease the monetary motivation to see patients in large numbers and increase the incentive to spend more time with individuals. Salaries are determined by the marketplace salaries for physicians in comparable large group practices.

Research[link]

Mayo Clinic researchers contribute to the understanding of disease processes, best clinical practices, and translation of findings from the laboratory to the clinical practice. Nearly 400 doctoral level physicians and research scientists are employed, with an additional 2,800 allied health personnel and students with appointments in research.^[4] In 2010, more than 2,300 research protocols were reviewed by the Mayo Clinic Institutional review board and 8,000 ongoing human research studies. These research initiatives led to more than 5,000 research publications and review articles in peer-review journals.^[4]

Education[link]

Drs. William and Charles Mayo were proponents of education since very early in the history of Mayo Clinic. In 1917, they helped found and develop the medical school at the University of Minnesota with a two million dollar donation. Until the early 1970s, consulting physicians at Mayo Clinic in Rochester, Minnesota held joint appointments as professors at the University of Minnesota medical school. The Mayo Clinic was a pioneer in helping to establish the current residency education system. In 1972, Mayo Clinic opened the doors of its own medical school (Mayo Medical School) in Rochester, which is known for its contributions the medical field.^[10]

Innovation[link]

Dr. Henry Stanley Plummer became a partner in the Clinic practice in 1901. He is considered by many American physicians to be the "architect of the modern medical practice" and a primary reason for Mayo Clinic's early success. He designed many of the systems which are now universally used around the world today, such as a shared, individual dossier-style medical record and an interconnecting telephone system. While the Mayo brothers excelled as surgeons, Dr. Plummer is largely credited with establishing and developing the diagnostic and clinical aspects of the practice. Dr. Louis B. Wilson was hired by the Clinic in 1907—at Dr. Henry Plummer's urging—to establish research and diagnostic laboratories.

Since about the year 2000, Mayo Clinic has also become known for achieving high quality at low cost. One extensive study found that the cost paid by insurers to treat Medicare patients in their last three years of life (the most expensive years) was only 54% of comparable costs in nearby clinics and hospitals. Mayo Clinic has been researched and presented many times during the passing of the 2009 healthcare reform bills in US Congress as a model to reduce healthcare costs while increasing quality for the nation. However, Mayo Clinic issued an open letter stating the healthcare reform bills as written in July 2009 would not reduce costs or increase quality nationwide.^[11]

The Biomedical Imaging Resource (BIR) at Mayo Clinic is dedicated to the advancement of research in the biomedical imaging and visualization sciences. The BIR provides expertise and advanced technology related to these fields, including image acquisition, processing, display and analysis; volume visualization; computer graphics; virtual reality and virtual environments; image databases; computer workstations, networks and programming. The BIR group developed the biomedical imaging software Analyze.

Leadership[link]

Mayo Clinic is led by President and CEO John Noseworthy, M.D. In May 2009, it was announced that when previous CEO Denis Cortese retires in November 2009, Dr. John Noseworthy would be named the new President and CEO.^[12]

After his retirement from Mayo in November 2009, Dr. Cortese became director of the Health Care Delivery and Policy Program at Arizona State University (ASU), Foundation Professor at ASU, and President of the Healthcare Transformation Institute. On July 29, 2010, EGHC, parent company of Essence Healthcare and other subsidiaries, announced that Dr. Cortese would join its Board of Directors.^[13]

Rankings[link]

In 2011, Mayo Clinic, Rochester, was ranked as the #3 overall hospital in the United States by U.S. News & World Report. A total of 4,825 hospitals were considered and ranked in 16 specialties from cancer and heart disease to respiratory disorders and urology; 140, or less than 3 percent of the total, were ranked in even one of the 16 specialties. Of the 140 hospitals that are ranked in one or more specialties, 17 qualified for the Honor Roll by earning high scores in at least six specialties. Mayo Clinic, Rochester, was ranked in the top 10 in all but one of 16 specialties, in the top 5 in 12 specialties, and was the #1 ranked hospital in four specialties.^[14]

U.S. News & World Report – Mayo Clinic, Rochester, 2011 Rankings by Medical Specialty

Additional images[link]

• 

  Gonda building from cafeteria.

• 

  Gonda building from 3rd Avenue SW.

• 

  Inside the Gonda building looking south toward the Mayo building.

• 

  The Plummer building.

• 

  The Opus Imaging Research Building.

• 

  Mayo Brothers U.S. Commemorative Stamp issued 1964

• 

  The Guggenheim Building in Rochester, MN.

Bibliography[link]

• Clapesattle, Helen. The Doctors Mayo (University of Minnesota Press, 1941; later editions are abridged).
• Fye, W. Bruce "The Origins and Evolution of the Mayo Clinic from 1864 to 1939: A Minnesota Family Practice Becomes an International 'Medical Mecca'", Bulletin of the History of Medicine Volume 84, Number 3, Fall 2010 pp. 323–357 in Project MUSE

See also[link]

• Mayo Medical School
• Mayo Clinic Diet
• SPARC Innovation Program
• American Legacy Foundation
• Medical centers in the United States
• Galvanic Vestibular Stimulation
• Mayo Clinic Center for Innovation

References[link]

External links[link]

Wikimedia Commons has media related to: Mayo Clinic

• Official site of Mayo Clinic
• Official site of Mayo Clinic Health System
• Mayo Clinic College of Medicine

Coordinates: 44°01′20″N 92°28′00″W / 44.0222°N 92.4666°W / 44.0222; -92.4666

Hunter Doherty "Patch" Adams
Adams in Anaheim, California, May 15, 2008
Born	(1945-05-28) May 28, 1945 (age 67) Washington, D.C., U.S.
Nationality	United States
Education	M.D., Virginia Commonwealth University
Alma mater	George Washington University
Home town	Arlington, Virginia
Spouse	Linda Edquist (1975–98; divorced)
Children	Atomic Zagnut Adams Lars Zig Edquist Adams

Hunter Doherty "Patch" Adams (born May 28, 1945, in Washington, D.C.) is an American physician, social activist, citizen diplomat and author. He founded the Gesundheit! Institute in 1971. Each year he organizes a group of volunteers from around the world to travel to various countries where they dress as clowns in an effort to bring humor to orphans, patients, and other people.^[1]

Adams is currently based in Urbana, Illinois. In collaboration with the institute, he promotes an alternative health care model, not funded by insurance policies.^[1]

Early life[link]

Adams had a difficult childhood. His father, an officer in the United States Army, had fought in Korea, and died while stationed in Germany when Adams was still a teenager.^[1] After his father's death, Adams returned to the United States with his mother and brother. Upon his return, Adams has stated that he encountered institutional injustice which made him a target for bullies at school. As a result, Adams was unhappy and became actively suicidal. After being hospitalized three times in one year for wanting to end his life, he decided "you don't kill yourself; you make revolution."^{[citation needed]}

Early career[link]

After graduating (1963) from Wakefield High School,^[2] Adams completed pre-med coursework at the George Washington University. He began medical school without an undergraduate degree, and earned his Doctor of Medicine degree at Virginia Commonwealth University (Medical College of Virginia) in 1971. In the late 1960s one of his closest friends (a man, not a woman as depicted in the Patch Adams film) was murdered. Convinced of the powerful connection between environment and wellness, he believes the health of an individual cannot be separated from the health of the family, community, and the world. While working in an adolescent clinic at MCV, in his final year of med school, he met Linda Edquist, a fellow VCU student who volunteered in the clinic. Soon after graduation, Patch, Linda, and friends founded the Gesundheit! Institute (originally known to many as the Zanies), which ran as a free community hospital for 12 years.

Adams and Edquist married in 1975 and had two sons, Atomic Zagnut "Zag" Adams and Lars Zig Edquist Adams. The couple divorced in 1998.^[3]

Gesundheit! Institute[link]

A revamped Gesundheit! Institute, envisioned as a free, full-scale hospital and health care eco-community, is planned on 316 acres (128 ha) in Pocahontas County, West Virginia. Its goal is to integrate a traditional hospital with alternative medicine, with the organization developing educational programs in sustainable systems design targeted to medical students and the general public.

Since the 1990s Adams has supported the Ithaca Health Alliance (IHA),^[4] founded as the Ithaca Health Fund (IHF) by Paul Glover. In January 2006 IHA launched the Ithaca Free Clinic, bringing to life key aspects of Adams' vision. Adams has also given strong praise to Health Democracy, Glover's book written and published the same year.

In October 2007, Adams and the Gesundheit Board unveiled its campaign to raise $1 million towards building a Teaching Center and Clinic on its land in West Virginia. The Center and Clinic will enable Gesundheit to see patients and teach health care design.

Adams urges medical students to develop compassionate connections with their patients. His prescription for this kind of care relies on humor and play, which he sees as essential to physical and emotional health. Ultimately, Adams wants the Gesundheit! Institute to open a 40-bed hospital in rural West Virginia that offers free, holistic care to anyone who wants it.^[5]

Adams was awarded the Peace Abbey Courage of Conscience Award on January 29, 1997.^[6]

In 2008, Adams agreed to become honorary chair of the "International Association for the Advancement of Creative Maladjustment" or IAACM. In a number of his speeches and essays, Martin Luther King, Jr. had called for such an IAACM, but none was ever created. MindFreedom International, a nonprofit coalition that Gesundheit! belongs to as a sponsor group, launched the IAACM to support "creative maladjustment" and social change.^[7]

In media[link]

The 1998 film Patch Adams was based on Adams' life and views on medicine. Adams has criticized the film, saying it eschewed an accurate representation of his beliefs in favor of commercial viability. He said that out of all aspects of his life and activism, the film portrayed him merely as a funny doctor.^[8] Patch Adams also said of Robin Williams in an interview, "He made $21 million for four months of pretending to be me, in a very simplistic version, and did not give $10 to my free hospital. Patch Adams, the person, would have, if I had Robin's money, given all $21 million to a free hospital in a country where 80 million cannot get care."^[9]

However, in another interview, Adams did clarify that he did not hate Williams^[10], and Williams has actively supported St. Jude Children's Research Hospital for several years.^[11]

As a speaker, Dr. Adams travels around the globe lecturing about his medicine methods. ^[12].

Bibliography[link]

• Adams, Patch; Maureen Mylander (1998). Gesundheit! : bringing good health to you, the medical system, and society through physician service, complementary therapies, humor, and joy. Rochester, Vermont: Healing Arts Press. ISBN 978-0-89281-781-8. http://lccn.loc.gov/99187488. Retrieved 2008-12-16. 
• Adams, Patch; Maureen Mylander (1993). Gesundheit! : bringing good health to you, the medical system, and society through physician service, complementary therapies, humor, and joy. Rochester, Vermont: Healing Arts Press. ISBN 978-0-89281-442-8. http://lccn.loc.gov/92007008. Retrieved 2008-12-16. 
• Adams, Patch; Maureen Mylander (1998). Gesundheit! [sound recording]. Los Angeles, California: NewStar Media. ISBN 978-0-7871-1828-0. http://lccn.loc.gov/00717433. Retrieved 2008-12-16.  4 sound cassettes (ca. 6 hr.) : digitally mastered, Dolby processed.
• Adams, Patch (1998). House calls. cartoons by Jerry Van Amerongen. San Francisco, California: Robert D. Reed Publishers. ISBN 978-1-885003-18-8. http://lccn.loc.gov/98034266. Retrieved 2008-12-16. 
• Bourque, Judith (1999). The real Patch Adams (videorecording) / a film by Judith Bourque. Oley, PA: Bullfrog Films. ISBN 978-1-56029-811-3. http://lccn.loc.gov/2003389123. Retrieved 2008-12-16.  1 videocassette (53 min.) : sd., col. ; 1/2 in.
• Graham, John (1999). It’s up to us. foreword by Patch Adams. Langley, Washington: Giraffe Project. ISBN 978-1-893805-00-2. http://lccn.loc.gov/99097193. Retrieved 2008-12-16. 

References[link]

External links[link]

	Biography portal
	United States portal
	Medicine portal

Wikiquote has a collection of quotations related to: Patch Adams

Wikimedia Commons has media related to: Patch Adams

• Official website
• Patch Adams at the Internet Movie Database

Dalai Lama
Gendun Drup, 1st Dalai Lama
Reign	1391–1474
Tibetan	ཏཱ་ལའི་བླ་མ་
Wylie transliteration	taa la'i bla ma
Pronunciation	[taːlɛː lama]
THDL	Dalai Lama
Pinyin Chinese	Dálài Lǎmā
Royal House	Dalai Lama / Takla

The Dalai Lama is a high lama in the Gelug or "Yellow Hat" branch of Tibetan Buddhism. The name is a combination of the Sino-Mongolian word далай (dalai) meaning "Ocean" and the Tibetan word བླ་མ་ bla-ma (with a silent "b") meaning "chief, high priest".^[1]

In religious terms, the Dalai Lama is believed by his devotees to be the rebirth of a long line of tulkus who are considered to be manifestations of the bodhisattva of compassion, Avalokiteśvara. Traditionally, the Dalai Lama is thought of as the latest reincarnation of a series of spiritual leaders who have chosen to be reborn in order to enlighten others. The Dalai Lama is often thought to be the leader of the Gelug School, but this position belongs officially to the Ganden Tripa, which is a temporary position appointed by the Dalai Lama who, in practice, exerts much influence. The line of Dalai Lamas began as a lineage of spiritual teachers; the 5th Dalai Lama assumed political authority over Tibet.

For certain periods between the 17th century and 1959, the Dalai Lamas sometimes directed the Tibetan government, which administered portions of Tibet from Lhasa. The 14th Dalai Lama remained the head of state for the Central Tibetan Administration ("Tibetan government in exile") until his retirement on March 14, 2011. He has indicated that the institution of the Dalai Lama may be abolished in the future, and also that the next Dalai Lama may be found outside Tibet and may be female.^[2] The Chinese government was very quick to reject this and claimed that only it has the authority to select the next Dalai Lama.^[3]

[edit] The original use of the name Dalai Lama

In 1578 the Mongol ruler Altan Khan bestowed the title Dalai Lama on Sonam Gyatso. The title was later applied retrospectively to the two predecessors in his reincarnation line, Gendun Drup and Gendun Gyatso. Gendun Gyatso was also Sonam Gyatso's predecessor as abbot of Drepung monastery. However, the 14th Dalai Lama asserts that Altan Khan did not intend to bestow a title as such and that he intended only to translate the name "Sonam Gyatso" into Mongolian.

... many writers have mistranslated Dalai Lama as "Ocean of Wisdom". The full Mongolian title, "the wonderful Vajradhara, good splendid meritorious ocean", given by Altan Khan, is primarily a translation of the Tibetan words Sonam Gyatso (sonam is "merit").^[4]

The 14th Dalai Lama commented:

The very name of each Dalai Lama from the Second Dalai Lama onwards had the word Gyatso [in it], which means "ocean" in Tibetan. Even now I am Tenzin Gyatso, so the first name is changing but the second part [the word "ocean"] became like part of each Dalai Lama's name. All of the Dalai Lamas, since the Second, have this name. So I don't really agree that the Mongols actually conferred a title. It was just a translation.^[5]

Whatever the intention may have been originally, the Mongolian "Dalai", which does not have any meaning as a Tibetan term, came to be understood commonly as a title.

The name or title Dalai Lama in Mongolian may also have derived originally from the title taken by Temüjin or Genghis Khan when he was proclaimed emperor of a united Mongolia during 1206. Temüjin took the name Čingis Qāghan or "oceanic sovereign", the anglicized version of which is Genghis Khan.^[6]

Tibetans address the Dalai Lama as Gyalwa Rinpoche ("Precious Victor"), Kundun ("Presence"), Yishin Norbu ("Wish fulfilling Gem") and so on.^[7]

Sonam Gyatso was an abbot at the Drepung Monastery who was considered widely as one of the most eminent lamas of his time. Although Sonam Gyatso became the first lama to have the title "Dalai Lama" as described above, since he was the third member of his lineage, he became known as the "Third Dalai Lama". The previous two titles were conferred posthumously upon his supposed earlier incarnations.

Yonten Gyatso (1589–1616), the 4th Dalai Lama, and a non-Tibetan, was the grandson of Altan Khan.

The tulku tradition of the Dalai Lama has evolved into, and been inaugurated as, an institution:

The institution of the Dalai Lama has become, over the centuries, a central focus of Tibetan cultural identity; "a symbolic embodiment of the Tibetan national character." Today, the Dalai Lama and the office of the Dalai Lama have become focal points in their struggle towards independence and, more urgently, cultural survival. The Dalai Lama is regarded as the principal incarnation of Chenrezig (referred to as Avalokiteshvara in India), the bodhisattva of compassion and patron deity of Tibet. In that role, the Dalai Lama has chosen to use peace and compassion in his treatment of his own people and his oppressors. In this sense the Dalai Lama is the embodiment of an ideal of Tibetan values and a cornerstone of Tibetan identity and culture.^[8]

Verhaegen mentions the trans-polity influence that the Institution of the Dalai Lama has had historically in areas such as western China, Mongolia, Ladakh in addition to the other Himalayan Kingdoms:

The Dalai Lamas have also functioned as the principal spiritual guide to many Himalayan kingdoms bordering Tibet, as well as western China, Mongolia and Ladakh. The literary works of the Dalai Lamas have, over the centuries, inspired more than fifty million people in these regions. Those writings, reflecting the fusion of Buddhist philosophy embodied in Tibetan Buddhism, have become one of the world's great repositories of spiritual thought.^[9]

The current Dalai Lama is often called "His Holiness" (HH) by Westerners (by analogy with the Pope), although this does not translate to a Tibetan title.

Before the 20th century, European sources often referred to the Dalai Lama as the "Grand Lama". For example, in 1785 Benjamin Franklin Bache mocked George Washington by terming him the "Grand Lama of this Country".^[10] Some in the West believed the Dalai Lama to be worshipped by the Tibetans as the godhead.^[11]

History[link]

Part of a series on Tibetan Buddhism
History
Timeline · Related-topics
Schools
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Key concepts
Three marks of existence · Skandha · Cosmology · Saṃsāra · Rebirth · Bodhisattva · Dharma · Dependent origination · Karma
Major figures
Gautama Buddha · Padmasambhava · Je Tsongkhapa · Dalai Lama · Panchen Lama · Lama · Karmapa Lama · Rinpoche · Geshe · Terton · Tulku
Practices and attainment
Buddhahood · Avalokiteśvara · Four stages of enlightenment · Tantric yoga · Paramitas · Meditation · Laity
Major monasteries
Changzhug · Drepung · Dzogchen · Ganden · Jokhang · Kumbum  · Labrang · Mindroling · Namgyal · Narthang · Nechung · Pabonka · Palcho · Ralung · Ramoche · Sakya · Sanga · Sera · Shalu · Tashilhunpo · Tsurphu · Yerpa
Major festivals
Chotrul Duchen · Dajyur · Losar · Monlam · Sho Dun
Texts
Kangyur · Tengyur · Tibetan canon · Mahayana sutras · Nyingma Gyubum
Art
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Outline  · Comparative studies  · Culture  · List of topics  · Portal
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Kublai Khan

Güshi Khan

During 1252, Kublai Khan granted an audience to Drogön Chögyal Phagpa and Karma Pakshi, the 2nd Karmapa. Karma Pakshi, however, sought the patronage of Möngke Khan. Before his death in 1283, Karma Pakshi wrote a will to protect the established interests of his sect by advising his disciples to locate a boy to inherit the black hat. His instruction was based on the premise that Buddhist ideology is eternal, and that Buddha would send emanations to complete the missions he had initiated. Karma Pakshi's disciples acted in accordance with the will and located the reincarnated boy of their master. The event was the beginning of the teacher reincarnation system for the Black-Hat Line of Tibetan Buddhism. During the Ming Dynasty, Emperor Yongle bestowed the title Great Treasure Prince of Dharma, the first of the three Princes of Dharma, upon the Black-Hat Karmapa. Various sects of Tibetan Buddhism responded to the teacher reincarnation system by creating similar lineages.

Unification of Tibet[link]

In the 1630s, Tibet became entangled in power struggles between the rising Manchu and various Mongol and Oirat factions. Ligden Khan of the Chakhar, retreating from the Manchu, set out to Tibet to destroy the Yellow Hat sect. He died on the way to Qinghai (Koko Nur) in 1634.^[12] His vassal Tsogt Taij continued the fight, even having his own son Arslan killed after Arslan changed sides. Tsogt Taij was defeated and killed by Güshi Khan of the Khoshud in 1637, who would in turn become the overlord of Tibet, and act as a "Protector of the Yellow Church."^[13] Güshi helped the Fifth Dalai Lama to establish himself as the highest spiritual and political authority in Tibet and destroyed any potential rivals. The time of the Fifth Dalai Lama was, however, also a period of rich cultural development.^{[citation needed]}

The Fifth Dalai Lama's death was kept secret for fifteen years by the regent (Tibetan: སྡེ་སྲིད།, Wylie: sde-srid), Sanggye Gyatso. This was apparently done so that the Potala Palace could be finished, and to prevent Tibet's neighbours taking advantage of an interregnum in the succession of the Dalai Lamas.^[14]

Tsangyang Gyatso, the Sixth Dalai Lama, was not enthroned until 1697. Tsangyang Gyatso enjoyed a lifestyle that included drinking, the company of women, and writing love songs.^[15] In 1705, Lobzang Khan of the Khoshud used the sixth Dalai Lama's escapades as excuse to take control of Tibet. The regent was murdered, and the Dalai Lama sent to Beijing. He died on the way, near Koko Nur, ostensibly from illness. Lobzang Khan appointed a new Dalai Lama who, however was not accepted by the Gelugpa school. Kelzang Gyatso was discovered near Koko Nur and became a rival candidate.

The Dzungars invaded Tibet in 1717, and deposed and killed Lobzang Khan's pretender to the position of Dalai Lama. This was widely approved. However, they soon began to loot the holy places of Lhasa, which brought a swift response from Emperor Kangxi in 1718; but his military expedition was annihilated by the Dzungars, not far from Lhasa.^[16][17]

A second, larger, expedition sent by Emperor Kangxi expelled the Dzungars from Tibet in 1720 and the troops were hailed as liberators. They brought Kelzang Gyatso with them from Kumbum to Lhasa and he was installed as the seventh Dalai Lama in 1721.^[18]

After him [Jamphel Gyatso the VIIIth Dalai Lama (1758–1804)], the IXth and Xth Dalai Lamas died before attaining their majority: one of them is credibly stated to have been murdered and strong suspicion attaches to the other. The XIth and XIIth were each enthroned but died soon after being invested with power. For 113 years, therefore, supreme authority in Tibet was in the hands of a Lama Regent, except for about two years when a lay noble held office and for short periods of nominal rule by the XIth and XIIth Dalai Lamas.

It has sometimes been suggested that this state of affairs was brought about by the Ambans—the Imperial Residents in Tibet—because it would be easier to control the Tibet through a Regent than when a Dalai Lama, with his absolute power, was at the head of the government. That is not true. The regular ebb and flow of events followed its set course. The Imperial Residents in Tibet, after the first flush of zeal in 1750, grew less and less interested and efficient. Tibet was, to them, exile from the urbanity and culture of Peking; and so far from dominating the Regents, the Ambans allowed themselves to be dominated. It was the ambition and greed for power of Tibetans that led to five successive Dalai Lamas being subjected to continuous tutelage.^[19]

Thubten Jigme Norbu, the elder brother of the present 14th Dalai Lama, describes these unfortunate events as follows:

It is perhaps more than a coincidence that between the seventh and the thirteenth holders of that office, only one reached his majority. The eighth, Gyampal Gyatso, died when he was in his thirties, Lungtog Gyatso when he was eleven, Tsultrim Gyatso at eighteen, Khadrup Gyatso when he was eighteen also, and Krinla Gyatso at about the same age. The circumstances are such that it is very likely that some, if not all, were poisoned, either by loyal Tibetans for being Chinese-appointed impostors, or by the Chinese for not being properly manageable.^[20]

Throne awaiting Dalai Lama's return. Summer residence of 13th Dalai Lama, Nechung, Tibet.

Thubten Gyatso, the 13th Dalai Lama, assumed ruling power from the monasteries, which previously had great influence on the Regent, during 1895. Due to his two periods of exile in 1904–1909, to escape the British invasion of 1904, and from 1910–1912 to escape a Chinese invasion, he became well aware of the complexities of international politics and was the first Dalai Lama to become aware of the importance of foreign relations. After his return from exile in India and Sikkim during January 1913, he assumed control of foreign relations and dealt directly with the Maharaja and the British Political officer in Sikkim and the king of Nepal rather than letting the Kashag or parliament do it.^[21]

Thubten Gyatso issued a Declaration of Independence for his kingdom in Central Tibet from China during the summer of 1912 and standardised a Tibetan flag, though no other sovereign state recognized the independence.^[22] He expelled the Ambans and all Chinese civilians in the country, and instituted many measures to modernise Tibet. These included provisions to curb excessive demands on peasants for provisions by the monasteries and tax evasion by the nobles, setting up an independent police force, the abolishment of the death penalty, extension of secular education, and the provision of electricity throughout the city of Lhasa in the 1920s.^[23] Thubten Gyatso died in 1933.

The 14th Dalai Lama was not formally enthroned until 17 November 1950, during the People's Republic of China invasion of the kingdom. In 1951, he and the Tibetan government formally accepted the Seventeen Point Agreement by which Tibet was formally incorporated into the People's Republic of China. Fearing for his life in the wake of a revolt in Tibet in 1959, the 14th Dalai Lama fled to India where he has led a government in exile since.^[24][25] With the aim of launching guerrilla operations against the Chinese, the CIA funded the Dalai Lama $1.7 million a year in the 1960s.^[26] In 2001, he ceded his absolute power over the government to an elected parliament of selected Tibetan exiles. His original goal was full independence for Tibet, but by the late 1980s, he was seeking high-level autonomy instead.^[27] He is still seeking greater autonomy from China, although Dolma Gyari, deputy speaker of the parliament-in-exile has stated "If the middle path fails in the short term, we will be forced to opt for complete independence or selfdetermination as per the UN charter".^[28]

Residence[link]

Starting with the 5th Dalai Lama and until the 14th Dalai Lama's flight into exile during 1959, the Dalai Lamas spent winters at the Potala Palace and summers at the Norbulingka palace and park. Both are in Lhasa and approximately 3 km apart.

Following the failed 1959 Tibetan uprising, the 14th Dalai Lama sought refuge in India. The then Indian Prime Minister, Jawaharlal Nehru, allowed in the Dalai Lama and his coterie of Tibetan government officials. The Dalai Lama has since lived in exile in Dharamshala, in the state of Himachal Pradesh in northern India, where the Central Tibetan Administration is also established. Tibetan refugees have constructed and opened many schools and Buddhist temples in Dharamshala.^[29]

Searching for the reincarnation[link]

The search for the 14th Dalai Lama took the High Lamas to Taktser in Amdo

By the Himalayan tradition, phowa (Tibetan) is the discipline that transfers the mindstream to the intended body. Upon the death of the Dalai Lama and consultation with the Nechung Oracle, a search for the Lama's reincarnation, or yangsi (yang srid), is conducted. Traditionally it has been the responsibility of the High Lamas of the Gelugpa Tradition and the Tibetan government to find his reincarnation. The process can take around two or three years to identify the Dalai Lama, and for the 14th, Tenzin Gyatso it was four years before he was found. The search for the Dalai Lama has usually been limited historically to Tibet, although the third tulku was born in Mongolia. Tenzin Gyatso, though, has stated that he will not be reborn in the People's Republic of China.^[30] In his autobiography, Freedom In Exile, he states that if Tibet is not free, he will reincarnate elsewhere."

The High Lamas used several ways in which they can increase the chances of finding the reincarnation. High Lamas often visit the holy lake, called Lhamo La-tso, in central Tibet and watch for a sign from the lake itself. This may be either a vision or some indication of the direction in which to search and this was how Tenzin Gyatso was found. It is said that Palden Lhamo, the female guardian spirit of the sacred lake, Lhamo La-tso, promised Gendun Drup, the 1st Dalai Lama in one of his visions "that she would protect the reincarnation lineage of the Dalai Lamas." Ever since the time of Gendun Gyatso, the 2nd Dalai Lama, who formalised the system, the Regents and other monks have gone to the lake to seek guidance on choosing the next reincarnation through visions while meditating there.^[31]

The particular form of Palden Lhamo at Lhamo La-tso is Gyelmo Maksorma, "The Victorious One who Turns Back Enemies". The lake is sometimes referred to as "Pelden Lhamo Kalideva", which indicates that Palden Lhamo is an emanation of the goddess Kali, the shakti of the Hindu God Shiva.^[32]

Lhamo Latso ... [is] a brilliant azure jewel set in a ring of grey mountains. The elevation and the surrounding peaks combine to give it a highly changeable climate, and the continuous passage of cloud and wind creates a constantly moving pattern on the surface of the waters. On that surface visions appear to those who seek them in the right frame of mind.^[33]

It was here that during 1935, the Regent, Reting Rinpoche, received a clear vision of three Tibetan letters and of a monastery with a jade-green and gold roof, and a house with turquoise roof tiles, which led to the discovery of Tenzin Gyatso, the 14th Dalai Lama.^[34][35][36]

High Lamas may also have a vision by a dream or if the Dalai Lama was cremated, they will often monitor the direction of the smoke as an indication of the direction of the rebirth.^[30]

Once the High Lamas have found the home and the boy they believe to be the reincarnation, the boy undergoes a series of tests to affirm the rebirth. They present a number of artifacts, only some of which belonged to the previous Dalai Lama, and if the boy chooses the items which belonged to the previous Dalai Lama, this is seen as a sign, in conjunction with all of the other indications, that the boy is the reincarnation.

If there is only one boy found, the High Lamas will invite Living Buddhas of the three great monasteries together with secular clergy and monk officials, to confirm their findings and will then report to the Central Government through the Minister of Tibet. Later a group consisting of the three major servants of Dalai Lama, eminent officials and troops will collect the boy and his family and travel to Lhasa, where the boy would be taken, usually to Drepung Monastery to study the Buddhist sutra in preparation for assuming the role of spiritual leader of Tibet.^[30]

However, if there are several possibilities of the reincarnation, in the past regents and eminent officials and monks at the Jokhang in Lhasa, and the Minister to Tibet would decide on the individual by putting the boys' names inside an urn and drawing one lot in public if it was too difficult to judge the reincarnation initially.^[37]

List of Dalai Lamas[link]

This article contains Chinese text. Without proper rendering support, you may see question marks, boxes, or other symbols instead of Chinese characters.

This article contains Indic text. Without proper rendering support, you may see question marks or boxes, misplaced vowels or missing conjuncts instead of Indic text.

There have been 14 recognised reincarnations of the Dalai Lama:

	Name	Picture	Lifespan	Recognised	Enthronement	Tibetan/Wylie	Tibetan pinyin/Chinese	Alternative spellings
1	Gendun Drup		1391–1474	–	N/A[38]	དགེ་འདུན་འགྲུབ་ dge 'dun 'grub	Gêdün Chub 根敦朱巴	Gedun Drub Gedün Drup Gendun Drup
2	Gendun Gyatso		1475–1542	–	N/A[38]	དགེ་འདུན་རྒྱ་མཚོ་ dge 'dun rgya mtsho	Gêdün Gyaco 根敦嘉措	Gedün Gyatso Gendün Gyatso
3	Sonam Gyatso		1543–1588	?	1578	བསོད་ནམས་རྒྱ་མཚོ་ bsod nams rgya mtsho	Soinam Gyaco 索南嘉措	Sönam Gyatso
4	Yonten Gyatso		1589–1617	?	1603	ཡོན་ཏན་རྒྱ་མཚོ་ yon tan rgya mtsho	Yoindain Gyaco 雲丹嘉措	Yontan Gyatso, Yönden Gyatso
5	Ngawang Lobsang Gyatso		1617–1682	1618	1622	བློ་བཟང་རྒྱ་མཚོ་ blo bzang rgya mtsho	Lobsang Gyaco 羅桑嘉措	Lobzang Gyatso Lopsang Gyatso
6	Tsangyang Gyatso		1683–1706	1688	1697	ཚངས་དབྱངས་རྒྱ་མཚོ་ tshang dbyangs rgya mtsho	Cangyang Gyaco 倉央嘉措	Tsañyang Gyatso
7	Kelzang Gyatso		1708–1757	?	1720	བསྐལ་བཟང་རྒྱ་མཚོ་ bskal bzang rgya mtsho	Gaisang Gyaco 格桑嘉措	Kelsang Gyatso Kalsang Gyatso
8	Jamphel Gyatso		1758–1804	1760	1762	བྱམས་སྤེལ་རྒྱ་མཚོ་ byams spel rgya mtsho	Qambê Gyaco 強白嘉措	Jampel Gyatso Jampal Gyatso
9	Lungtok Gyatso		1805–1815	1807	1808	ལུང་རྟོགས་རྒྱ་མཚོ་ lung rtogs rgya mtsho	Lungdog Gyaco 隆朵嘉措	Lungtog Gyatso
10	Tsultrim Gyatso		1816–1837	1822	1822	ཚུལ་ཁྲིམས་རྒྱ་མཚོ་ tshul khrim rgya mtsho	Cüchim Gyaco 楚臣嘉措	Tshültrim Gyatso
11	Khendrup Gyatso		1838–1856	1841	1842	མཁས་གྲུབ་རྒྱ་མཚོ་ mkhas grub rgya mtsho	Kaichub Gyaco 凱珠嘉措	Kedrub Gyatso
12	Trinley Gyatso		1857–1875	1858	1860	འཕྲིན་ལས་རྒྱ་མཚོ་ 'phrin las rgya mtsho	Chinlai Gyaco 成烈嘉措	Trinle Gyatso
13	Thubten Gyatso		1876–1933	1878	1879	ཐུབ་བསྟན་རྒྱ་མཚོ་ thub bstan rgya mtsho	Tubdain Gyaco 土登嘉措	Thubtan Gyatso Thupten Gyatso
14	Tenzin Gyatso		born 1935	1937	1950 (currently in exile)	བསྟན་འཛིན་རྒྱ་མཚོ་ bstan 'dzin rgya mtsho	Dainzin Gyaco 丹增嘉措	Tenzing Gyatso

There has also been one nonrecognised Dalai Lama, Ngawang Yeshey Gyatso, declared 28 June 1707, when he was 25 years old, by Lha-bzang Khan as the "true" 6th Dalai Lama – however, he was never accepted as such by the majority of the population.^[17][39][40]

Future of the position[link]

The 14th Dalai Lama, Tenzin Gyatso in 2007

The main teaching room of the Dalai Lama in Dharamshala, India

In the mid-1970s, Tenzin Gyatso, the Fourteenth Dalai Lama, told a Polish newspaper that he thought he would be the last Dalai Lama. In a later interview published in the English language press he stated, "The Dalai Lama office was an institution created to benefit others. It is possible that it will soon have outlived its usefulness."^[41] These statements caused a furor amongst Tibetans in India. Many could not believe that such an option could even be considered. It was further felt that it was not the Dalai Lama's decision to reincarnate. Rather, they felt that since the Dalai Lama is a national institution it was up to the people of Tibet to decide whether the Dalai Lama should reincarnate.^[42]

The government of the People's Republic of China (PRC) has claimed the power to approve the naming of "high" reincarnations in Tibet, based on a precedent set by the Qianlong Emperor of the Qing Dynasty. The Qianlong Emperor instituted a system of selecting the Dalai Lama and the Panchen Lama by a lottery that used a golden urn with names wrapped in clumps of barley. This method was used a few times for both positions during the 19th century, but eventually fell into disuse. In 1995, the Dalai Lama chose to proceed with the selection of the 11th reincarnation of the Panchen Lama without the use of the Golden Urn, while the Chinese government insisted that it must be used. This has led to two rival Panchen Lamas: Gyaincain Norbu as chosen by the Chinese government's process, and Gedhun Choekyi Nyima as chosen by the Dalai Lama.

During September 2007 the Chinese government said all high monks must be approved by the government, which would include the selection of the 15th Dalai Lama after the death of Tenzin Gyatso. Since by tradition, the Panchen Lama must approve the reincarnation of the Dalai Lama, that is another possible method of control.

In response to this scenario, Tashi Wangdi, the representative of the 14th Dalai Lama, replied that the Chinese government's selection would be meaningless. "You can't impose an Imam, an Archbishop, saints, any religion...you can't politically impose these things on people," said Wangdi. "It has to be a decision of the followers of that tradition. The Chinese can use their political power: force. Again, it's meaningless. Like their Panchen Lama. And they can't keep their Panchen Lama in Tibet. They tried to bring him to his monastery many times but people would not see him. How can you have a religious leader like that?"^[43]

The Dalai Lama said as early as 1969 that it was for the Tibetans to decide whether the institution of the Dalai Lama "should continue or not".^[44] He has given reference to a possible vote occurring in the future for all Tibetan Buddhists to decide whether they wish to recognize his rebirth.^[45] In response to the possibility that the PRC may attempt to choose his successor, the Dalai Lama has said he will not be reborn in a country controlled by the People's Republic of China or any other country which is not free.^[30][46] According to Robert D. Kaplan, this could mean that "the next Dalai Lama might come from the Tibetan cultural belt that stretches across northern India, Nepal, and Bhutan, presumably making him even more pro-Indian and anti-Chinese".^[47]

See also[link]

Buddhism portal

• Engaged Spirituality
• Tibet Autonomous Region

Notes and references[link]

Bibliography[link]

• Dowman, Keith. (1988). The Power-Places of Central Tibet: The Pilgrim's Guide. Routledge & Kegan Paul Ltd., London. ISBN 0-7102-1370-0 (pbk).
• Laird, Thomas (2006). The Story of Tibet: Conversations with the Dalai Lama. Grove Press, New York. ISBN 978080218271.
• Richardson, Hugh E. (1984). Tibet and its History. Second Edition, Revised and Updated. Shambhala. Boston & London. ISBN 0-87773-376-7 (pbk)
• Murray Silver, "When Elvis Meets the Dalai Lama," (Bonaventure Books, Savannah, 2005).
• Norbu, Thubten Jigme and Turnbull, Colin M. (1968). Tibet: An account of the history, the religion and the people of Tibet. Reprint: Touchstone Books. New York. ISBN 0-671-20559-5.
• Schulemann, Guenther: Geschichte der Dalai-Lamas, Harrassowitz, Leipzig, 1958.
• Sheel, R. N. Rahul. "The Institution of the Dalai Lama." The Tibet Journal, Vol. XIV No. 3. Autumn 1989.
• Stein, R. A. (1972). Tibetan Civilization. Stanford University Press. ISBN 0-8047-0806-1 (cloth); ISBN 0-8047-0901-7 (paper).
• Diki Tsering, edited & introduced by Khedroob Thondop. (2000). Dalai Lama, My Son: A Mother's Story. Virgin Publishing Company, London. ISBN 0-7535-0571-1.
• Verhaegen, Ardy (2002). The Dalai Lamas: The Institution and Its History. Emerging Perceptions in Buddhist Studies, no. 15. New Delhi, India: D. K. Printworld (P) Ltd. ISBN 81-246-0202-6.
• Yá Hánzhāng 牙含章: The Biographies of the Dalai Lamas (Dálài Lǎmá chuán 达赖喇嘛传; Beijing, Foreign Languages Press 1993); ISBN 7-119-01267-3.

Further reading[link]

• Dalai Lama. (1991) Freedom in Exile: The Autobiography of the Dalai Lama. San Francisco, CA.
• Goodman, Michael H. (1986). The Last Dalai Lama. Shambhala Publications. Boston, MA.
• Mullin, Glenn H. (2001). The Fourteen Dalai Lamas: A Sacred Legacy of Reincarnation. Clear Light Publishers. Santa Fe, NM. ISBN 1-57416-092-3.

External links[link]

Wikimedia Commons has media related to: Dalai Lamas

• Official website
• Dalai Lama at the Open Directory Project

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