When I had cancer, and again when I was recovering from encephalitis, people would ask, “Do they know what caused it?” I found this rather interesting, that people were so concerned to find a reason. I wasn’t concerned about the reason at all, I was concerned about getting well. But people wanted to know. I think it was partly their anxiety; illness is frightening, particularly ones as serious as I had. But also it is the way we are built; we are hardwired to look for reasons why things happen. Even when there isn’t a reason, the brain tends to concoct one. The possibility that things happen for no reason is very disconcerting. One of the Buddha’s core insights is that everything does happen for a reason—except that his reasons were different than what people usually thought.
So there is teaching in Buddhism about why illness happens, but the teaching is that we become ill because we have a body. It seems silly to say so, especially in our world of modern medicine where we want a cat scan or MRI to explain it to us. But from a Buddhist point of view, illness is the price we pay for the gift of life. A few years back the book Tuesdays With Morrie was a huge best seller. It told the story of Morrie—a retired college professor, who had a terrible degenerative neurological illness—and Mitch, the book’s author, who visited his old professor every Tuesday.
Morrie had an unusually upbeat attitude toward his illness, and kept reassuring his old student Mitch. “It’s all right, Mitch,” he said. “It’s all right that I have this illness. That’s the price I’m paying for the gift of having lived. The payment got deferred, but now it’s come due. It’s all right.”
I don’t think Morrie was a Buddhist, but he was expressing a Buddhist view. To use a trite current expression, our human life is “pay to play.” The human body is miraculous, but it is not immortal. We all know this intellectually, but when illness comes, we forget. We want to know why, forgetting that we already know why, and that knowledge is liberation.

Hi Lewis,
Could we just say that illness happens because illness happens?
Of course, this would not please those who need to have a reason, although there are reasons for some illnesses.
I came from the school where if I got a headache, etc , it was because I wasn’t taking spiritual or emotional care of myself. Felt guilty if I didn’t feel up to par.
Took many years to give that one up, with the help of my husband who said ’sometimes a cold is just a cold”…no deeper than that.”
Hi Lewis: I agree with you 100 percent. Most of the time you only have yourself to blame for being sick.Like myself, i have copd from smooking all my life. I’ve been taking prednisone for ten years now & it has many side effects. ~ Joe
Lew, could you comment from a Zen perspective on the effect of karma on illness?
There are many Buddhists who believe their illness is the consequence of negative karma from a previous life …
And that their suffering from illness pays off the karmic debt.
Thanks.
Maybe illness is a Buddhist reminder of death; it’s always there, inevitably so, but not in the forefront of our minds. We have a “dress rehearsal” when we’re ill, of the balance of the cycle, from birth, to death.
why illness happens? why do I ask this question?
When illness happened to other living beeings I asked this question just to find a reason not fitting to my own circumstances (cancer due to smoking – I dont smoke, so I dont get cancer) I wanted to calm myself to keep the illusion of living without suffering.
Meeting this illusion in my personal illness I learned not to ask “why?”. Instead I try to ask for the “hidden messages”:
- What insights does it offer to me?
- Whats rumbling inside me confronted with my end?
- …
Thus – if there is any real reason for illness: It happens to wake me up.
This is a topic I have frequently contemplated. Reason seeking brain function is useful for survival. Pattern observation allowing us to avoid some of the things that cause illness. It may be useful to be grateful for this brain function, thanking it, noting it, and letting it go. Thanks for pointing out the letting go. The reason seeking, cause observation is quite powerful and engaging. It can be overwhelming and even oppressive. That appears to be one of the marks of this brain function. Interesting that stepping back and noting it can allow this brain tool to be even more effective. Letting go of it when appropriate or using the information it provides when reasonably possible. Not pushing it away, not being swept away. Grateful for this attribute of consciousness that is caring for our well being. The brain is caring for us. An excellent daily practice opportunity.
Re karma & illness: Well, in the largest sense the net of karma is why everything happens. But even the buddha and many buddhist great saints had many difficult illnesses, so if the doctrine John says is true then all of us, even the most blessed, have difficult karma from our past.
So I’m not sure, practically speaking, how much it helps our practice now to think of illness as repaying karmic debt, except insofar (and this may be important) as it helps us take responsibility for our illness and deal with it. Suzuki Roshi, when asked about his illness, said, “Cancer is my friend.”
That is how he dealt with that.
I think Pope John said something similar. He said
“It (the cancer) wants to live, also.”
I’m interested in mind’s tendency toward explanation. At times, this has seemed mostly a male mind-habit; that is, men look for explanations so that they can “fix” things. But, of course, females also seek causes and explanations. It’s one of the ways human mind dances with the world.
I’ve noticed in myself how quickly I move to “fix” difficult things in my life, and the lives of others. It takes work, real practice, for me to slow down enough to simply experience the feelings and emotions that arise when a “difficult thing” first arises. But, when I can do that, then the “fix” sometimes comes more easily, even when it means that there’s nothing to fix.
I think it’s human to look for explanations, but I also think we ask for explanations of others’ illnesses in hopes of avoiding them ourselves. That’s human, too, though futile. I don’t know how it works for others, but for me, accepting that I am “of the nature to get ill” helps me savor this day when I am not ill.
With the last supper Christ equated the body with food, and blood with drink, in that, Spirit can be witnessed in every composite form where we formerly assigned a kind of mindless act of oral gratification, and also divorced any sense of sacredness and ritual… a sacred rite of passage of remembering who puts all the forms together as One gift, of giving, bringing together a structure of water for the entire purpose of seeing God all around us, in everything. We only have to see it, because it exists at all times, and in every form. And once we see God in form, the form takes on a sacredness, from within one’s own heart, and this begins an opening, into the domain of spirit, as light.
I smile, then cry.
Thoughts are food, numbers are like tea, letters are like rice.
The immanent.
Lewis and all,
Maybe sometimes for whatever reason, we choose or it happens that we get more suffering in this lifetime than others – maybe, as in my life, for my whole life, now at 51 years. If Bodhichitta and Bodhisattvas are not just pretty stories, and to me they are not, maybe we actually suffer so someone else doesn’t have to – someone we might not know but still, in our Buddha heart, we love. People say, “How can you do that? With all you deal with?” I say, “But look at all I don’t deal with, and I’m happy. It’s not the length of life but the quality. And it’s not the reason, because I am not this body and it’s quirks and breakdowns. My body can’t dance, but my soul sure can, and always always will.
Tara
Thank you Lewis for reminding us of the obvious. As you say people are looking for special causes. Like my brother in law who has gotten the idea somewhere that it takes 10 years after a big trauma for a cancer to develop. So now he blames a 10 year old family drama for his newly discovered cancer. The hard thing is how to tell the truth to people without getting them upset?
noelle
After my heart attacks…everybody seemed interested in “Why”. I got interested in “How”. How might I relate to my illness…how might it help me serve others?
After my surgery a very famous Tibetan teacher kindly called to wish me well. I knew he had heart problems himself, so I asked him how he dealt with it all….the drama, the confusion, the precariousness, the beauty.
He said simply, “…well it’s good to have a heart….and if we have one we should expect it will have problems”.
Then he giggled and reminded me to rest.