From Here to Serenity
Early Thursday morning I awake clear, refreshed, and ready for basti. The rest of the treatments go wonderfully, and by Friday, I'm done. But lifestyle and self-care in the weeks following panchakarma will demand my attention. To make sure everything continues well, the panchakarma coordinator carefully reviews my dietary guidance, suggests lifestyle modifications (which include sexual abstinence for the length of time one goes through treatment—one week in my case), and gives directions for continuing basti every Saturday for a month. I marvel at his patience educating clients rendered blissfully spaced out by five days of treatments. By now, I am so heavily invested in this process—and so enamored of my new comfort food—that continuing the kitchari fast another two weeks seems a desirable inconvenience. Aside from the actual treatment time, which is borderline ecstatic, panchakarma feels a bit like early pregnancy. You're not really sick, but you don't feel well, the stomach's uncertain, and you're tired all the time. This is not like lolling about a spa. This rest is hard work, so all-consuming I could barely do anything else. In this fatigue, even keeping a journal seemed a gargantuan feat. But given the depth of the changes engineered, the amount of rest the treatment requires seems a reasonable cost. Naram explains that "rest makes panchakarma more effective. Many times, activity can disturb vata, thus blocking the process of panchakarma."
Five days of treatment is common fare in stateside panchakarma clinics, but after five days, it felt like I was just beginning. Dr. Ramkumar, director of the Ayurvedic Trust in Coimbatore, India, tells me that a careful reading of Ayurvedic scripture points to longer time frames, perhaps four to six months (no wonder it's known as the health care of royals) and very precise protocols. Every winter, Americans and Europeans fill half of his 100-bed hospital, where, Ramkumar says, "a course of Kerala oil treatments lasts a minimum of five weeks."
Undergoing treatment in India actually has many perks—namely, longer treatments and lower fees. In America, programs and lodging run between $1,500 and $3,000 per week. Many people will need to travel as well. One month of panchakarma in India commonly costs $1,000. Flights from New York average $1,200. Even with airfare, India is a bargain. And Indian clinics offer many more therapies than are available in the United States. But if details like planks on the floor instead of padded massage tables, and therapists chatting during treatment put you off, then it's best to try panchakarma closer to home. Dr. Robert Svoboda, author of Prakruti, Your Ayurvedic Constitution (Lotus Press, 1989), is the only American who has graduated from an Indian Ayurvedic college and is licensed to practice in India. Svoboda rarely recommends going to India for your first panchakarma experience unless you have lived there before.
To those considering panchakarma in India, Ramkumar offers the following suggestions: "Be ready for Indian hygiene. The standards are much lower than in America, although that is not important for this particular process, where we are looking at internal cleansing." He further advises that one "come prepared for total rest. Don't expect to even take walks, but you can bring a tape player to listen to soothing music." To this, Svoboda adds the desirability of bringing your own enema bag or syringe for basti, or using disposable bags, as "there is considerable HIV and hepatitis C in India."