Question: If I have a condition that needs major surgery, should I simply not be attached to my body, and let karma take its course by forgoing surgery?
Answer: (As whether surgery should be undertaken depends on nature of the sickness, the following is a general answer.) We must take reasonable care of our bodies. Reasonable care is not attachment as we need our present forms that come with this precious human rebirth to learn and practise the Dharma well. We know our bodies are subject to ageing, sickness and death, which is why we should take good care of it. Again, the need is reasonable care. Just as healthy food and drink that sustain our bodies is like reasonable medication for healing hunger and thirst, appropriate medicine for healing sickness is reasonable medication too.
Just as we should never let a sick child be, to ‘let karma take its course’ without offering medication, we should not ignore worse sickness as adults when they occur to us too. Our destiny is created and changed not by passively letting karma take its course, but by actively steering it in the right direction. The Buddha did not teach us about karma just so that we let everything be without doing anything proactive, including when having major illnesses.
Even when it comes to practising Nianfo (mindfulness of the name of Amitabha Buddha – ‘Amituofo’) when sick, it should be reasonably coupled with medication, surgery and such, as can be seen in this case: http://youtube.com/watch?v=PCCp6cmYBoY This is not because Nianfo is inadequate for healing, but that our negative karma might be strong while our Nianfo skills might be weak, which makes medication a useful boost to our efforts. Note too, that as above, due to our karmic conditions as beings of this Saha World (with endurance of suffering), death is still eventual, while complete and lasting healing is upon reaching Amituofo’s Pure Land.
When very sick, as in with high risk of dying, should we relinquish any thought of healing. When certain or with low chance of survival, or in great doubt, the following advice of Great Master Yinguang on wholehearted Nianfo with the aspiration to reach Pure Land should be followed: https://purelanders.com/2015/12/30/guidance-before-support-chanting-%E5%8A%A9%E5%BF%B5%E5%89%8D%E5%BC%80%E7%A4%BA-pure-land-passport-section-2 This can hasten healing in two ways – in the Saha World or by reaching Pure Land.
Question: How does the Heart Sutra’s teaching on form/emptiness apply to this situation?
Answer: Emptiness refers to our minds and matter (these bodily forms) being empty of (or without any) fixed unchanging nature. While the Heart Sutra reminds us that ‘form is emptiness’, to loosen our attachment to forms, it also reminds us that ’emptiness is form’, to loosen our attachment to emptiness. This is the balanced way to relate to form/emptiness. It is the right Middle Path in attitude and action.
When we realise our forms (bodies) are giving way to serious sickness, we should loosen attachment to our bodies (as this might be the final stretch of life when our bodies are expiring), without forgoing reasonable care. If we forgo reasonable care, with the singular thought that ‘form is emptiness’ only, we would be attached to emptiness. This would be wrong.
Thus, the summary is to always take reasonable care, but without pining to live forever in this Saha World, because it is impossible. This is why we should practise Nianfo to reach Pure Land eventually, where we will have immeasurable life’s unlimited time for perfecting Dharma learning and practice, to become swiftly and fully liberated.
(Note: Never follow advice of those who claim there is no need to see doctors when severely sick, as this can prove fatal physically and spiritually. There is a case of someone who taught so boldy, who nevertheless admitted to seeing a dentist! He also propagated ‘end of the world’ nonsense, that led to many to lose their money, jobs and families as they gave them up before this doomsday that did not come. Such teachers should not be listened to at all. We should only follow teachings in the sutras, as explained by the great patriarchs.)