With a piercing gaze, the Dalai Lama pointed his index finger at me.

“How do you propose to teach Tibetan medicine to Westerners?” he demanded.

My heart pounded, and my tongue stuck to the roof of my mouth. I was only 19 years old, working on an undergraduate major in medical anthropology. Having received a grant to study the cause and course of illness in the Tibetan tradition, I began organizing courses for Westerners to study Tibetan medicine at the Kopan Monastery outside Kathmandu.

I first arrived there two years earlier, having traveled overland to Nepal from the Netherlands before starting my degree at the University of California at Berkeley. The Shah was still in Iran, and the Russians hadn’t yet invaded Afghanistan. After nearly dying from dengue fever in a makeshift Nepali hospital, I first arrived at Kopan Monastery. After settling in, under Lama Thubten Yeshe’s direction, I soon found myself deeply moved by Tibetan culture and philosophy and the profound perspectives of Tibetan medicine on sickness, old age and death.

The first year that I ran courses for Westerners to study this ancient healing art coincided with the end of the Cultural Revolution. The common understanding was that there were only 12 Tibetan physicians outside of Tibet, most of whom had escaped in 1959 as the Chinese began occupying the country. One, Dr. Ngodup- Tsering Dingang, was our initial instructor, but he then became inaccessible. When I was unable to find a replacement, Lama Yeshe resolved to take me to see H.H. The Dalai Lama to request assistance.

Although initially overcome by a sense of awe in his presence, words finally started to flow. My heart still pounding, I explained that the Western students were first given an orientation in Tibetan history and culture. They were also taught basic elements of Tibetan philosophy and how to sit in meditation. At that point the Tibetan doctor would begin daily three-hour teaching sessions. I explained that these were translated by a young man who had grown up in a missionary school and spoke both Tibetan and English but had no grasp of the practice of medicine. His rote translations seemed incomprehensible at first. During afternoon sessions the class met without the doctor and worked to build a cultural bridge to gain insights into the content and meaning of his teachings. Later, students had the opportunity to observe the doctor treating local villagers. Most students also received treatments.

The Dalai Lama listened carefully to my explanation. After I’d finished there was a long silence. He gazed downward and stroked his chin. Several times he cleared his throat as he appeared to consider what had been said. He finally looked back at me and again pointing his index finger said quite slowly and deliberately: “Good scheme … very good scheme. … I think we can help.”

It was in that moment that the vision for my life’s work crystallized. The mission is to bring together the best of modern medicine and traditional health arts. It would be another 25 years before I opened Manakai o Malama Integrative Healthcare Group and Rehabilitation Center. The long journey to prepare included a medical degree with boards in preventive medicine, a master’s degree in environmental health and one in business. Solid experience in the practice of conventional medicine was essential, and it took some time to formulate a detailed plan.

After receiving over a half-million visits during nearly 20 years, Manakai’s team of 50 people has brought together diverse providers from multiple health professions to treat with a whole-patient, culturally sensitive approach. This collaborative approach still continues its work to optimize health and prevent and treat illness in its many manifestations, both obvious and obscure. Over the years, our medical doctors have worked closely with our psychologists and our naturopathic physicians. Our acupuncturists, chiropractors, physical therapists, occupational therapists and medical massage therapists all contribute to successful treatment outcomes for a broad range of health care issues. Niolopua, Manakai’s sleep lab, has proved to be another important piece of the puzzle.

At the request of one of Hawaii’s largest insurers, Manakai created an intensive outpatient program for patients with chronic pain and published the data. We also have run regular groups for patients to manage diabetes and obesity. The team offers primary care and treatment of veterans and injured workers. This approach to care, now called integrative medicine, has become particularly relevant given rapid changes to our health care system. This new medical specialty has led the way for the Patient Centered Medical Home and demonstrated the ability to improve outcomes while reducing costs across large groups of patients. None of this would ever have developed however, were it not for the initial inspiration of the Dalai Lama and my other teachers in Nepal, to whom I remain eternally grateful.

Ira Zunin is a practicing physician. He is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.