introduction 13
temples, mosques and churches, where they undergo aesthetically rich healing
processes that engage the senses through music, smells and a scenic environ-
ment. Although many report only moderate improvement after therapy, some
recount undergoing a transformative process that brought them to a state
similar to what Ajit describes, a level of well-being that is more vibrant than
the normal “healthy” state they experienced before their illness. Here health
does not signify merely an absence of illness—it is not merely “remedial,” to
borrow Alter’s (1999) label for contemporary biomedical and social science
assumptions about health. Rather, it is something that can be continually
improved upon or “changed,” as they say in Kerala when describing what is
accomplished in healing.
An awareness of the pleasantness of the process of healing thus leads to a
recognition of the contingency of time in healing and the limitations of the
concept of curing for understanding what is accomplished in therapy. Th ere is
no word in Malayalam, the primary language of Kerala, that has quite the same
meaning as the English term “cure” or that depicts the allopathic orientation
to treatment. Curing implies an eradication of a pathogen or a return to a state
of normalcy, or a “baseline,” that existed prior to an illness. “Cure” is in some
contexts more ideal or ambitious than the verb māruka, meaning “change” (or,
more loosely, “improve,” “get better”), which is used in Kerala to describe the
improvement one attains through therapy. Th e concept of “curing,” or even
“healing,” meanwhile, falls short of capturing the sense of moving to a higher
level or the auspicious transformation reported by some who were using reli-
gious therapies.
Since people in Kerala have several, mainstream therapeutic options, many
patients discontinue unpleasant treatments to pursue less abrasive forms of
healing. Some people with intractable mental illnesses that have persisted
for years have found a “solution” to their problems, not in achieving a cure,
but in resolving to live with their problems in the aesthetically and spiritually
engaging environment of a religious healing center. In other words, they have
decided to live in a process of therapy that is “pleasant” in the sense of being
positively aesthetically engaging and where the contingency of time is de-
emphasized. Th e concern about the aesthetic quality of the process of therapy
in ayurveda and the actions of those who choose to live with their problems
in a religious center suggest an orientation to the process and goals of therapy
that is less teleological, less oriented to absolute endings than the orienta-
tion in allopathic medical practice. Both approaches involve working toward
goals, but the ayurvedic and religious orientations attend to the quality of the
present—the process—while moving forward, whereas allopathic therapy
proceeds with a more emphatic focus on the future and with a concern that