Qualities of the Upasthata - Paricharaka (assistant)

The sutra has listed four factors in the treatment process: the practitioner, the medicine/procedure, the patient and the assistant. The assistant is of equal importance to the other three and is the one who moves the treatment forward. In treatment, a kind and pleasant environment is a great support for the patient. The sutra describes the treatment process in clinical settings with an emphasis on the qualities of the assistant, the nurse, and other helpers. However, the treatment may also take place at home, where the assistants will be parents, friends, siblings, etc. The qualities relate to any assistant who serves the patient during treatment.

The assistant should be a professional in the sense of providing treatment to the patient. He knows exacly how to prepare a medicine, herb decoction or herb powder, he knows how to measure out and prepare the individual doses, etc.

At the same time, the assistant has to be intelligent, so that the treatment corresponds to the current condition of the patient. For example, the Bhishak knows that a certain medicine is suitable for the patient. The Paricharak (assistant) knows the medicine is rather strong and that the patient is weak, and thus administers the medicine after the patient has eaten a meal. The assistant knows when and what meal the patient had, and thus the assistant uses his intelligence when administering medicine to the patient.

The assistant recognizes various moods in the patient during the treatment, and he continuously balances out the various moods with his clear, pure, conscious, self-assured and kind behaviour, creating a constructive healing spirit and environment. Thus the assistant is the keeper of the treatment, although the soul of the treatment is the Ayurvedic practitioner. At home, the role of the assistant is assumed by the family members who should have these qualities if they intend to take good care of an ill relative. An atmosphere of conflict should never be created around a patient receiving treatment.

The assistant performs the treatment. The Bhishak is the designer of the treatment and the assistant implements it. We are familiar with this from hospitals, where the doctor prescribes what is to be done and the nurses administer the treatment. The pressure to resolve the disease comes from her actions. This is a necessary factor responsible for the treatment and the assistant herself has four "legs" on which she stands. This can also be a family member who carries out the Bhishak's instructions. Such a person must be willing to carry out instructions, not just talk about them and not just to be seen as important. The Paricharak is not a drama queen, but somebody who has total self-control and is focused 100 % on the patient and the treatment.

There are four qualities to the assistant:  Anurakta - the term rakta means the bodily fluid that conveys the life force, and it is red (blood). If the blood stops circulating and begins to coagulate, so does the life. It is the basis of life in the body, the essence of the person. The term anu means something like deputy or vice, as in "vice-mayor", or sub-. Anurakta means something like the the vice-life force, support to the life force, and this involves compassion and empathy, somebody who can sense how the patient is feeling and can support them. 

Shuchi is the quality of clarity - it is 100 % clear to the assistant what is wrong with the patient and what has to be done to administer the treatment. The assistant understands the doctor 100 % and is able to perceive the patient's current state with 100 % clarity. The assistant is meant to be the conveyor of the treatment and there should be no other interest governing her behavior - the doctor and patient must be able to rely on her. The cleanliness referred to here includes moral cleanliness, honesty, reliability, humilty, dedication to the patient, and deep capacity for empathy.

Daksha here is the same as for the Bhishak, a set of professional skills. This means the assistant knows above all how to remain detached and put her personal emotions aside. For example, an assistant who over-identifies with the patient, who is unable to do something that may cause them temporary discomfort but is necessary to do to cure the disease, is not professional.

Buddhi-mán is the quality of intelligence, which is the fourth "leg" of the assistant, without which the other qualities cannot be coordinated. It has to be instantaneous. 

These are also the qualities of any assistant to any process, not just in health care. Such a person is an ideal team member.